Jimmy Kimmel has lately been urging Donald Trump supporters to sign up for health insurance through Trumpcare, which offers comprehensive coverage at affordable prices. Moreover, it’s insurance through private companies, not the government. A lot of Trump fans have taken to Facebook and Twitter to praise Kimmel for finally seeing the light on what a great president Trump is and what a good job he’s doing with health insurance, saving people from the evils of Obamacare.
Of course, what Kimmel is doing is sneakily rebranding Healthcare.gov insurance as “Trumpcare” even though it’s exactly the same as “Obamacare,” though a lot of people seem not to realize this. It’s tricky, but if it gets Trump fans to sign up their families for good health insurance, in the end they benefit.
Incidentally, one of Trump’s attempts to sabotage Obamacare unintentionally ended up making cheaper and even free policies available to a lot of people. This came as a surprise, but maybe Trump ought to get credit for it anyway. (Hey, penicillin was discovered by accident.) It has to do with something called cost-sharing reduction (CSR) payments. Basically, the Affordable Care Act includes two types of subsidies, one to lower monthly premiums and the other to help with out-of-pocket spending in the form of deductibles, coinsurance, and co-pays, collectively known as “cost-sharing” because the individual pays a share of the cost of medical care.
The Affordable Care Act says insurance companies have to cover some of the cost sharing for working people earning up to 250 percent of the poverty level, provided they have a “Silver”-level policy, and it also obligates the government to reimburse the companies for that. But while the ACA requires the reimbursements, it doesn’t unambiguously authorize them, at least as some lawyers read the bill. (There’s a lawsuit working its way through the courts about this.) Trump used this unintended legal loophole as an excuse to stop making the payments, even though they had hitherto been made since the ACA went into effect.
But this doesn’t let the insurance companies off the hook. They still have to reduce cost-sharing for the lower-income insured. So to make up the difference they raised premiums on Silver policies. But remember, premiums are subsidized for about 80 percent of people getting coverage from Healthcare.gov and the state-operated marketplaces. The amount of the subsidy is calculated by taking the cost of second-lowest-cost Silver policy available to the individual or family in question and subtracting it from a percentage of their income. (The exact percentage varies by incomes level.) That subsidy then applies to any policy you sign up for, no matter what the level.
The result is that many people can now get a cheap Bronze policy for free or just a few dollars, or even get a Gold policy (without cost-sharing reductions) for less money than a Silver plan. And the way this works out mathematically, the government is spending a lot more money on subsidies than it saved by ending the CSR reimbursements.
Anyway, here are some examples of Jimmy Kimmel’s promotion of the Affordable Care Act as “Trumpcare”:
Feel free to share those YouTube links with any Trump fans you know who need health insurance.