President Donald Trump reportedly wants to light the fuse that many experts say could cause the Affordable Care Act's individual insurance exchanges to crumble.
According to Politico's Josh Dawsey, Paul Demko, and Jennifer Haberkorn, Trump told White House aides in a Tuesday meeting that he wanted to end the cost-sharing-reduction payments that are part of the ACA.
The payments help to offset costs for insurers in exchange for offering more affordable coverage to low-income Americans. Experts say that without the payments premiums would likely skyrocket and insurers would drop out of the market.
Currently, the CSR payments are funded by the executive branch, but a House of Representatives lawsuit has alleged the payments are illegal since they should be appropriated by Congress, not the White House.
In 2016, a federal judge ruled in favor of the House, putting CSR payments in jeopardy. The Obama administration filed an appeal. Now the Trump administration must decide whether to continue or drop the appeal.
The Trump administration has committed to funding the payments through May as part of a deal to keep the federal government funded.
According to Politico, while Trump favors dropping the payments, some administration officials like Tom Price, the health and human services secretary, worry that if the CSR payments stopped, the Trump administration could be blamed for the resulting chaos in the insurance markets.
Concerns about the payments have already led some insurers to drop out of the ACA's exchanges in states such as Iowa and Virginia. Additionally, a group of 15 states and Washington, DC, filed a motion on Thursday to continue the Obama administration's appeal even if the Trump administration dropped the case.
"If successful, the suit could — to use the president's expression — 'explode' the entire act," the filing says. "Until recently, states and their residents could rely on the executive branch to respond to this attack. Now, events and statements, including from the president himself, have made clear that any such reliance is misplaced."
The Trump administration must provide an update to the US District Court of Appeals on Monday about whether it wishes to continue the case.
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