Stymied in his efforts to repeal the Affordable Care Act, President Donald Trump has threatened repeatedly to withhold the federal subsidy payments to health insurers that reduce the cost of copayments and deductibles that keep coverage affordable for people with low incomes. A new report  by the Congressional Budget Office calculates that insurance premiums would spike if Trump follows through on his threat – and ultimately cost the federal government more money. Vox’s health care reporter, Sarah Kliff, explains:

If the Trump administration were to end the cost-sharing reduction subsidies, CBO estimates that premiums for mid-level health plans would rise 20 percent in 2018 and 25 percent by 2025. Insurance plans would raise their premiums to offset the lost funding. And those higher premiums would mean the federal government has to spend $194 billion more in subsidies to help pay those higher premiums.  So to repeat that one more time: It will cost the federal government nearly $200 billion to end the cost-sharing reduction subsidies. For that extra spending, the federal government would have a market with higher premiums and less competition. Trump talks a lot about making deals. This does not sound like a very good one.

As of Tuesday, only two counties in the country are at risk of not have any insurers participate in their individual marketplaces next year. Edwin Park with the CBPP explains how ending CSR payments would dramatically increase the number of “bare” counties:

Other insurers would likely withdraw from the marketplaces altogether, leaving more consumers in counties with no marketplace plans, CBO finds. As a result, 1 million more people would be uninsured in 2018 than under current law. If the CSR payments stopped after insurers had already finalized premiums for 2018, insurers would suffer significant financial losses and even more insurers would leave the marketplaces, CBO notes.

Calling out a conflict of interest

The Baton Rouge Area Chamber (BRAC) is unhappy with Gov. John Bel Edwards’ 2016 executive order that requires manufacturers to create new jobs and seek local approval before they are exempted from paying property taxes that support local schools, police, parks and other services. BRAC President Adam Knapp, in a guest column in The Advocate, said Louisiana should take a page from neighboring Texas and create a streamlined approval process, so that corporations don’t have to petition several local governing bodies for tax forgiveness. But Dianne Hanley with Together Baton Rouge, which helped spearhead the reforms to the Industrial Tax Exemption Program, writes that Knapp has his facts wrong:

Texas, it turns out, is far stricter than Louisiana on corporate exemptions. Texas prohibits school districts from granting abatements, requires that each taxing body set formal criteria beforehand by which exemption applications will be evaluated and requires that every exemption get a public hearing and record vote by each local entity. Knapp’s misinformation about the Texas process that he gave to this paper was also presented to the School Board and Metropolitan Council last month when BRAC lobbied for the creation of a “review committee” to “streamline” approval of exemptions. There, BRAC went a step further, recommending BRAC itself conduct “economic impact” analyses for each exemption on behalf of this “review committee.” ….Together Baton Rouge would suggest that policy should prohibit any entity with a financial interest in an exemption from conducting a government’s analysis of the project’s “return on investment.”

Child food programs at risk

For decades, the USDA’s child nutrition programs have ensured millions of American children have access to the food they need to learn and grow. Subsidized school breakfast and lunch programs allow kids to eat nutritious meals at school, while afterschool and summer feeding programs ensure they don’t go hungry when school is out. An abundance of research shows the positive impact of these programs, but the Trump administration’s budget has put them on the chopping block — a cause for great concern across the country, but especially in poor, rural towns like Greenville, Mississippi. Tovin Lapan with the Hechinger Report reports from the Delta:

Many communities in the Mississippi Delta have better access to casinos, convenience stores and fast food than to grocery stores selling fresh fruits and vegetables. Sherry Jackson, who runs federal programs for the Greenville School District in the heart of the Mississippi Delta, views the proposed cuts with dismay. “[They] make me feel sick to my stomach,” she said. “There is nowhere else for parents to turn; we are the safety net,” she added. In Greenville, the people stitching that net together are loath to imagine what will happen if holes develop. On a humid Wednesday afternoon in April, children wearing khaki pants and polo shirts color-coded to their grade level trickled into the Boys and Girls Club of Greenville, one of five sites for Greenville’s 21st Century Community Learning Centers, an afterschool program. The center faces closure if the Trump budget passes.

Leave CHIP out of it

The Children’s Health Insurance Program (CHIP) serves nearly 9 million low-to-moderate income children nationwide, including 161,525 in Louisiana. Next month, Congress must take action to reauthorize the program for funding to continue to flow to the states without interruption. The program is relatively inexpensive, highly effective, and has a history of bipartisan support, so one would expect reauthorization to be little more than a formality. It could, however, get caught up in other partisan battles in Congress, causing great concern to families and child advocates across the nation. David Sandman, President and CEO of the New York Health Foundation writes for The Huffington Post:

It should be a no-brainer to continue a program that is so successful, that provides health care coverage and peace of mind to millions of Americans at a relatively low cost, and that has for two decades enjoyed bipartisan support. Yet we are left holding our breath wondering whether it will be renewed, whether states will have to scramble to find funding in their own tight budgets to continue the program, whether millions of kids will have their insurance taken away. Our leaders must choose: one path leads to continued gridlock and a loss of health and economic security for Americans. The other path leads us back toward a functional government as well as health care coverage, access, and financial protection. The right choice should be an obvious one, if not an easy one in this polarized environment. For the sake of millions of children across the country, our nation’s policymakers must choose wisely.

 

Number of the Day

4  –  Number of poor families with children receiving TANF cash assistance out of every 100 poor families with children in Louisiana – the lowest percentage in the nation. (Source: The Urban Institute)