This month, Trump reneged on a deal in which the president had been paying monthly subsidies to health insurers that offer policies to low- and middle-income individuals under the ACA, also known as Obamacare.
In return, these insurers have kept costs down for customers by forgoing co-payments and deductibles.
Without the federal subsidy — $9 billion during the current fiscal year — insurance rates for millions of Americans will jump dramatically.
CareFirst BlueCross BlueShield of Maryland now says it will seek another 20 percent rate rise on its ACA policies. That follows on the heels of an approved 50 percent increase.
The timing couldn’t be worse.
Enrollment begins Nov. 1. Yet there’s so much confusion neither of the ACA insurers in Maryland — CareFirst and Kaiser — may know by next month what their rates will be for 2018.
A delay in the enrollment period could mean fewer people signing up. Even more troubling is the additional rate hike, which could add substantially to the number of Marylanders dropping health coverage.
That’s bad news for hospitals, which could see uninsured citizens clogging emergency rooms. Bad debts and unpaid medical services could cost medical centers hundreds of millions of dollars.
This places Hogan in a tight spot. He’s not about to raise taxes to make up the difference for the 324,000 Marylanders on Obamacare. Yet he is running for re-election and a flare-up over the ACA could stimulate a heavy protest vote.
In Baltimore County, Trump’s knee-capping of the ACA will be an issue in the Republican primary for county executive.
Insurance Commissioner Al Redmer is running as a Republican for the county’s top job. His GOP foe, Del. Pat McDonough, won’t be shy about ripping into Redmer for approving CareFirst’s 50 percent rate request and his almost-certain approval of an additional hike.
Redmer also will be under the gun for not following the lead of states like Virginia that asked insurance companies to submit alternative rate proposals for its 2018 Obamacare policies: one that assumed Trump would continue paying the subsidy (known as cost-sharing reductions) to keep rates low, and the other based on Trump’s refusal to continue that subsidy.
The disruption to Maryland’s enrollment period could have been avoided had Redmer taken that path. Instead, he chose not to do so — a move that may force a delay in the enrollment period. He will face withering criticism for that decision in Baltimore County’s GOP primary.
Democrats won’t be any kinder to Redmer if he survives McDonough’s challenge in June. Trump’s actions assure that the denial of health care subsidies will be a hot-button issue in the 2018 elections.
Hogan has few options for rectifying this messy situation. Maryland’s budget finances are tight. There may not be much, if any, excess revenue he can throw into the health care pot as a stop-gap measure.
Meanwhile, Democrats in the General Assembly might force the issue by approving legislation requiring the Republican governor to allocate funds to insurance companies so they can lower the cost of ACA policies in Maryland.
Would Hogan veto such a measure in the midst of his re-election campaign?
This could become a dicey situation for the governor. While he remains personally popular, Trump’s controversial actions are not helping him.
All this could make for a fascinating election year both in the county and statewide.
Barry Rascovar’s blog is email@example.com. He can be reached at firstname.lastname@example.org.