Tag Archives: Healthcare

Maine governor will not expand Medicaid, ignoring voters

Maine governor will not expand Medicaid, ignoring voters

By Gina Cherelus

(Reuters) – Maine Republican Governor Paul LePage said on Wednesday he will not expand the state’s Medicaid program under Obamacare, ignoring a ballot initiative widely backed by voters, calling it “ruinous” for the state’s budget.

Maine looked set to become the first state in the nation to expand Medicaid by popular vote.

About 60 percent of voters in Maine approved the ballot proposal in Tuesday’s election, according to the Bangor Daily News newspaper.

Republicans in Washington have failed several times to pass legislation that would dismantle former President Barack Obama’s signature healthcare law.

LePage said he will not implement the expansion until it is fully funded by the Maine legislature.

“Credit agencies are predicting that this fiscally irresponsible Medicaid expansion will be ruinous to Maine’s budget,” LePage said in a statement. “I will not support increasing taxes on Maine families, raiding the rainy day fund or reducing services to our elderly or disabled.”

LePage said a previous Medicaid expansion in Maine in 2002 had created $750 million in debt to hospitals and took resources away from vulnerable people.

Maine has been prominent in the nation’s healthcare debate. U.S. Senator Susan Collins, a moderate Republican from Maine, helped block her party’s efforts to repeal Obamacare. Collins did not immediately respond to a request for comment on LePage’s decision.

Maine voters were asked to approve or reject a plan to provide healthcare coverage under Medicaid for adults under age 65 with incomes at or below 138 percent of the federal poverty level, which in 2017 is about $16,000 for a single person and about $22,000 for a family of two.

If implemented, about 70,000 additional state residents would be eligible for the Medicaid program, local media reported, in addition to the roughly 268,000 people who are currently eligible.

(Reporting by Gina Cherelus in New York; Editing by Daniel Wallis and Jeffrey Benkoe)

Voters in Maine approve expansion of Medicaid under Obamacare

Voters in Maine approve expansion of Medicaid under Obamacare

By Brendan O’Brien

(Reuters) – Voters in Maine on Tuesday approved a ballot initiative to expand the state’s Medicaid program under Obamacare, sending a clear signal of support for the federal healthcare law to lawmakers in the state and Washington D.C.

The approval of the ballot question in Maine comes after Republicans in Washington failed several times over the last few months to pass legislation that would dismantle the Affordable Care Act, former President Barack Obama’s signature healthcare law.

Maine has recently figured prominently in the nation’s debate on how to reform healthcare. U.S. Senator Susan Collins, a moderate Republican from Maine, helped block her party’s efforts to repeal Obamacare this year, which angered President Donald Trump.

Maine, which becomes the first U.S. state to approve Medicaid expansion by ballot initiative, is one of 19 states that has not expanded Medicaid under the Affordable Care Act.

About 60 percent of voters in Maine approved the ballot initiative, according to the Bangor Daily News newspaper.

Tuesday’s ballot asked Maine voters to approve or reject a plan to provide healthcare coverage under Medicaid for adults under the age of 65 with incomes at or below 138 percent of the federal poverty level, which in 2017 is about $16,000 for a single person and about $22,000 for a family of two.

The state’s Republican governor, Paul LePage, staunchly opposes expansion of federal health care insurance, vetoing legislation to do so on several occasions.

“I’ve said it before, “free” is very expensive to somebody,” LePage said in a radio address last week.

About 70,000 residents in Maine would be eligible for the state’s Medicaid program when and if state officials certify the results of the election. Lawmakers could vote to repeal or alter the referendum, much like they have recently for several citizen-initiated referendums, the Bangor Daily News reported.

“It is now the responsibility and the duty of the governor and the legislature to fully and faithfully implement this law,” the state’s Speaker of the House, Sara Gideon, said in a statement.

The Legislature’s Office of Fiscal and Program Review in Maine estimated that expansion of Medicaid would cost the state about $55 million and bring in about $525 million of federal money to the state each year, according to the Bangor Daily News.

(Reporting by Brendan O’Brien in Milwaukee; Editing by Nick Macfie)

Obamacare 2018 enrollment clouded by uncertainty

A man looks over the Affordable Care Act (commonly known as Obamacare) signup page on the HealthCare.gov website in New York in this October 2, 2013 photo illustration.

By Yasmeen Abutaleb

WASHINGTON (Reuters) – As Americans begin signing up for Obamacare health insurance plans on Wednesday, experts expect reduced participation as a bitter political debate clouds the program’s future.

Republicans in Congress have repeatedly failed to repeal and replace former President Barack Obama’s healthcare law, which they have said drives up costs for consumers and interferes with personal medical decisions. Democrats have warned that repeal would leave millions of Americans without health coverage.

President Donald Trump promised to kill the law in his 2016 election campaign, and he has taken executive and administrative actions to undermine it.

“The market’s going to be extremely confusing. There’s going to be entire complexity of choice,” said David Anderson, a health policy researcher at Duke University.

The Center for American Progress, a liberal think tank, estimated this week that 2018 enrollment would have held steady from 2017, with 12.2 million people either signing up for or being automatically re-enrolled in individual health coverage under the Affordable Care Act had there not been administration efforts to undercut it.

The Trump administration has cut the 2018 enrollment period in half to six weeks from Nov. 1 to Dec. 15 for states using the federal Healthcare.gov website. Enrollment previously ran until Jan. 31, and many consumers often signed up in the last two weeks, according to state officials and organizations that help people choose insurance.

Senate Republicans and Democrats are working on legislation to stabilize Obamacare markets in the short term. The nonpartisan Congressional Budget Office estimates that four million fewer people will sign up for Obamacare private insurance than previously forecast due to Trump administration policies.

Still, CBO expects total enrollment to reach 11 million in 2018, up from the around 10 million who obtained and paid for coverage in 2017.

The administration has cut off billions of dollars in subsidies that insurers use to discount out-of-pocket medical costs for low-income Americans, slashed Obamacare advertising and cut funding to groups that help people enroll in health insurance. Several insurers have exited Obamacare markets due to concerns over subsidies and other Trump actions.

The Department of Health and Human Services said on Monday that premiums for the most popular Obamacare plans would rise 37 percent in 2018. Americans eligible for Obamacare tax credits to buy insurance may pay less for coverage, but costs would increase for middle-class consumers who do not get subsidies.

“It’s been such a flood of information. A lot of the population thinks the Affordable Care Act has already been put under,” said Daniel Polsky, a professor at the University of Pennsylvania and executive director of the Leonard Davis Institute of Health Economics. “The strange premium increases are going to be very confusing for consumers.”

The Trump administration is now planning changes for 2019. Last week, it proposed a rule giving states more flexibility over the benefits that must be covered by insurance. Under Obamacare, all insurers have to cover a set of 10 benefits, such as maternity and newborn care and prescription drugs.

(This version of the story corrects reference to CBO estimate on enrollment in paragraphs 7-8, clarifies estimate from think tank in paragraph 5)

 

(Reporting By Yasmeen Abutaleb; Editing by Michele Gershberg)

 

Apple sees its mobile devices as platform for artificial intelligence

An Apple employee showcases the augmented reality on an iPhone 8 Plus at the Apple Orchard Shop in Singapore September 22, 2017. REUTERS/Edgar Su

By Jess Macy Yu

TAIPEI (Reuters) – Apple Inc  sees its mobile devices as a major platform for artificial intelligence in the future, Chief Operating Officer Jeff Williams said on Monday.

Later this week, Apple is set to begin taking pre-orders for its new smartphone, the iPhone X – which starts at $999 and uses artificial intelligence (AI) features embedded in the company’s latest A11 chips.

The phone promises new facial recognition features such as Face ID that uses a mathematical model of a person’s face to allow the user to sign on to their phones or pay for goods with a steady glance at their phones.

“We think that the frameworks that we’ve got, the ‘neural engines’ we’ve put in the phone, in the watch … we do view that as a huge piece of the future, we believe these frameworks will allow developers to create apps that will do more and more in this space, so we think the phone is a major platform,” Williams said.

He was speaking at top chip manufacturer Taiwan Semiconductor Manufacturing Company’s 30th anniversary celebration in Taipei, which was attended by global tech executives.

Williams said technological innovations, especially involving the cloud and on-device processing, will improve life without sacrificing privacy or security.

“I think we’re at an inflection point, with on-device computing, coupled with the potential of AI, to really change the world,” he said.

He said AI could be used to change the way healthcare is delivered, an industry he sees as “ripe” for change.

Williams said Apple’s integration of artificial intelligence wouldn’t be just limited to mobile phones.

“Some pieces will be done in data centers, some will be on the device, but we are already doing AI in the broader sense of the word, not the ‘machines thinking for themselves’ version of AI,” he said referring to the work of Nvidia Corp, a leader in AI.

Global tech firms such as Facebook, Alphabet Inc, Amazon, and China’s Huawei are spending heavily to develop and offer AI-powered services and products in search of new growth drivers.

Softbank Group Corp, which has significantly invested in artificial intelligence, plans a second Vision Fund that could be about $200 billion in size, the Wall Street Journal reported on Friday.

At Monday’s event, TSMC Chairman Morris Chang described his company’s relationship with Apple as “intense.”

Williams said the relationship started in 2010, the year Apple launched the iPhone 4, with both parties taking on substantial risk.

He credited Chang for TSMC’s “huge” capital investment to ramp up faster than the pace the industry was used to at the time. Apple decided to have 100 percent of its new iPhone and new iPad chips for application processors sourced at TSMC, and TSMC invested $9 billion to bring up its Tainan fab in a record 11 months, he said.

 

(Reporting by Jess Macy Yu, additional reporting by Eric Auchard, Editing by Miyoung Kim and Adrian Croft)

 

Obamacare whiplash leaves states, insurers with dueling price plans

FILE PHOTO: U.S. President Donald Trump smiles after signing an Executive Order to make it easier for Americans to buy bare-bone health insurance plans and circumvent Obamacare rules at the White House in Washington, U.S., October 12, 2017. REUTERS/Kevin Lamarque/File Photo

By Caroline Humer

NEW YORK (Reuters) – President Donald Trump’s reversals in the past week on maintaining Obamacare subsidies to insurers are sowing new confusion over what kind of health insurance will be available to consumers, and at what price, when enrollment for 2018 begins in two weeks.

Trump said last week his administration would stop paying billions of dollars in subsidies that help insurers give discounts to low-income households, one of several moves to dismantle the signature healthcare law of his Democratic predecessor, Barack Obama.

Since then, Trump has alternately supported, and dismissed, an effort by Republican and Democratic senators that would reinstate the subsidies for two years, until a broader replacement to the 2010 Affordable Care Act, commonly known as Obamacare, can be negotiated.

“We are worried that consumers on (Obamacare) plans will be confused by all the back and forth and proposed policy changes and that this will cause them to not seek out assistance,” said Bryna Koch, special projects coordinator at the Arizona Center for Rural Health, which helps consumers choose and sign up for individual health plans offered under Obamacare.

Trump, who promised during his election campaign to repeal and replace Obamacare, which he has called a “disaster,” has said the subsidies amount to a bailout for insurance companies.

By law, health insurers must still offer the discounts on deductibles, co-pays and other out-of-pocket costs, even if the government stops reimbursing them. Insurers say they do not profit from the subsidies.

Anticipating Trump’s move, insurers proposed higher prices on monthly premiums in 2018 to recoup the money. In all but a handful of states, they submitted two sets of premium rates – a lower rate to use if the subsidies remained, and a higher rate to use if the funding was cut.

LAST WORD ON SUBSIDIES?

The fate of the subsidies remained in limbo on Thursday. A senior White House aide said that Trump would demand steps toward repealing Obamacare in any healthcare legislation, comments that cast doubt on the prospects for the bipartisan effort to shore up insurance markets.

A California court is expected to consider on Monday a request by Democratic attorneys general to keep the subsidies flowing until a legal challenge to Trump’s decision is resolved.

If the funding is not restored when 2018 enrollment opens on Nov. 1, many consumers will see premium rates that are on average 20 percent higher than they would have been otherwise.

Even before Trump’s decision on the subsidies, the Congressional Budget Office said the Republican president’s policies to roll back Obamacare enrollment efforts would lead to 4 million fewer people signing up for insurance in 2018 than previously forecast. The CBO still expects 11 million people to sign up for next year – an increase from this year’s enrollment of 10 million.

The federal government has already halted a subsidy payment to the insurance industry for October. But leading insurers are not yet sure whether that is the last word.

Anthem Inc Chief Executive Officer Joseph Swedish told Reuters he could not yet predict how ending the subsidies or restating them through “potential congressional action” would affect pricing next year. Anthem has submitted premium rates that account for the subsidies being cut.

Should the subsidies be restored at any time after Nov. 1, insurers may be able to revert to the lower monthly premium rates, or provide rebates for consumers.

“A midyear change in premiums would be highly unusual, but this would be the right thing to do,” said Marc Harrison, CEO of Intermountain Healthcare, a Utah-based health plan and hospital chain. “Intermountain Healthcare would pursue this.”

Washington state’s insurance regulator said it would allow insurers to change rates as soon as practical – even the next month – if lawmakers reinstate the funding, an approach backed by the National Association of Insurance Commissioners. But that could run up against federal government objections.

The Affordable Care Act does not allow for changes to premium rates after they have been finalized, an official for the U.S. Department of Health and Human Services said. At the same time, the administration is working to approve higher rates in several states that did not take into account Trump’s cut in subsidies for 2018.

(Additional reporting by Yasmeen Abutaleb in Washington; Editing by Michele Gershberg and Peter Cooney)

U.S. Senate backers of Obamacare deal seek support but prospects unclear

U.S. Senate backers of Obamacare deal seek support but prospects unclear

By Yasmeen Abutaleb and Richard Cowan

WASHINGTON (Reuters) – Proponents of a bipartisan deal struck by two U.S. senators to stabilize Obamacare sought on Wednesday to win Republican support for the measure, which would restore subsidies to health insurers that President Donald Trump has scrapped.

With 2018 health insurance markets facing potential chaos, Republican Senator Lamar Alexander and Democratic Senator Patty Murray were hoping to build broad support for a short-term fix for former President Barack Obama’s signature healthcare law.

Their proposal would meet some Democratic objectives, such as reviving subsidies for Obamacare and restoring $106 million in funding for a federal program that helps people enroll in insurance plans.

In exchange, Republicans would get more flexibility for states to offer a wider variety of health insurance plans while maintaining the requirement that sick and healthy people be charged the same rates for coverage.

The Trump administration said last week it would stop paying billions of dollars to insurers to help cover out-of-pocket medical expenses for low-income Americans, part of the Republican president’s effort to dismantle the 2010 Affordable Care Act, known as Obamacare.

Trump and other Republicans have disparaged the payments to insurers as a “bailout” but the president on Tuesday indicated support for the efforts by Alexander and Murray as a one- or two-year fix while work continues to unwind the law.

While the two senators’ proposal has broad Democratic support, it is unclear how many Republicans will endorse it and whether Senate Majority Leader Mitch McConnell and House of Representatives Speaker Paul Ryan will allow a vote on the plan.

It also remained unclear how fully Trump supported the plan and whether he would sign it into law.

Republican Senator Susan Collins, a moderate who helped kill earlier efforts to repeal and replace the healthcare law, said she backed efforts to shore up Obamacare, but that it remained unclear if there would ultimately be enough support.

“Now, the White House is sending conflicting messages,” she told CNN in an interview on Wednesday, adding that the insurer payments had been “mischaracterized” as a boon for the industry.

Collins said she did not know if McConnell would schedule a vote but that “if it comes to the floor, I think the votes are there.” She said it also could win House approval if Trump “reiterates his support.”

Republicans, describing Obamacare as ineffective and a massive government intrusion in a key sector of the economy, have sought for seven years to repeal and replace it. Scrapping the law was also a top Trump campaign pledge. But the party, which has controlled the White House and Congress since January, has so far failed to make good on its promise.

Democrats have fought to defend Obamacare, which extended health insurance to 20 million Americans.

(Reporting by Yasmeen Abutaleb; Editing by Peter Cooney and Bill Trott)

U.S. states sue to block Trump Obamacare subsidies cut

U.S. President Donald Trump smiles after signing an Executive Order to make it easier for Americans to buy bare-bone health insurance plans and circumvent Obamacare rules at the White House in Washington, U.S., October 12, 2017. REUTERS/Kevin Lamarque TPX IMAGES OF THE DAY

By Yasmeen Abutaleb and Dan Levine

WASHINGTON/SAN FRANCISCO (Reuters) – Eighteen U.S. states sued President Donald Trump’s administration on Friday to stop him from scrapping a key component of Obamacare, subsidies to insurers that help millions of low-income people pay medical expenses, even as Trump invited Democratic leaders to negotiate a deal.

One day after his administration announced plans to end the payments next week, Trump said he would dismantle Obamacare “step by step.”

His latest action raised concerns about chaos in insurance markets. The subsidies cost $7 billion this year and were estimated at $10 billion for 2018, according to congressional analysts.

“As far as the subsidies are concerned, I don’t want to make the insurance companies rich,” Trump told reporters at the White House. “They’re making a fortune by getting that kind of money.”

Trump’s action took aim at a critical element of the 2010 law, his Democratic predecessor Barack Obama’s signature domestic policy achievement. Frustrated by the failure of his fellow Republicans who control both houses of Congress to repeal and replace Obamacare, Trump has taken several steps to chip away at it.

Democrats accused Trump of sabotaging the law.

Democratic attorneys general from the 18 states as well as Washington, D.C., filed a lawsuit in federal court in California later on Friday. The states include: California, Connecticut, Delaware, Kentucky, Illinois, Iowa, Maryland, Massachusetts, Minnesota, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia and Washington state.

The states will ask the court to force Trump to make the next payment. Legal experts said the states were likely to face an uphill battle in court.

“His effort to gut these subsidies with no warning or even a plan to contain the fallout is breathtakingly reckless,” New York Attorney General Eric Schneiderman said. “This is an effort simply to blow up the system.”

The new lawsuit would be separate from a case pending before an appeals court in the District of Columbia in which 16 Democratic state attorneys general are defending the legality of the payments.

If the subsidies vanish, low-income Americans who obtain insurance through Obamacare online marketplaces where insurers can sell policies would face higher insurance premiums and out-of-pocket medical costs. It would particularly hurt lower-middle-class families whose incomes are still too high to qualify for certain government assistance.

About 10 million people are enrolled in Obamacare through its online marketplaces, and most receive subsidies. Trump’s action came just weeks before the period starting on Nov. 1 when individuals have to begin enrolling for 2018 insurance coverage through the law’s marketplaces.

The administration will not make the next payment to insurers, scheduled for Wednesday, U.S. Attorney General Jeff Sessions said.

Senate Democratic leader Chuck Schumer expressed optimism about chances for a deal with Republicans to continue the subsidy payments.

“We’re going to have a very good opportunity to get this done in a bipartisan way” during negotiations in December on broad federal spending legislation, “if we can’t get it done sooner,” Schumer told reporters.

Trump offered an invitation for Democratic leaders to come to the White House, while also lashing out at them. “We’ll negotiate some deal that’s good for everybody. But they’re always a bloc vote against everything. They’re like obstructionists,” Trump told reporters.

The Senate failed in both July and September to pass legislation backed by Trump to repeal Obamacare due to opposition by a handful of Republican senators. One of them, Susan Collins, a moderate Republican from Maine who had been contemplating running for governor next year, on Friday said she planned to remain in the Senate and would use her voice in reforming the healthcare system.

SHARES OF INSURERS, HOSPITALS FALL

Hospitals, doctors, health insurers, state insurance commissioners and patient advocates decried Trump’s move, saying consumers will ultimately pay the price. They called on Congress to appropriate the funds needed to keep up the subsidy payments.

Shares of U.S. hospital companies and health insurers closed down on Friday after the subsidies announcement. Centene Corp <CNC.N> closed down 3.3 percent and Molina Healthcare <MOH.N> closed down 3.4 percent. Among hospital shares, Tenet Healthcare <THC.N> finished 5.1 percent lower and Community Health Systems <CYH.N> declined 4.0 percent.

The nonpartisan Congressional Budget Office has estimated that erasing the subsidies would increase the federal deficit by $194 billion over the next decade because the government still would be obligated under other parts of Obamacare to help lower-income people pay for insurance premiums.

Trump, who as a candidate last year promised to roll back the law formally called the Affordable Care Act, received applause for his latest action during an appearance on Friday before a group of conservative voters.

“It’s step by step by step, and that was a very big step yesterday,” Trump said. “And one by one, it’s going to come down, and we’re going to have great healthcare in our country.”

Earlier on Twitter he called Obamacare “a broken mess” that is “imploding,” and referred to the “pet insurance companies” of Democrats.

Republicans for seven years had vowed to get rid of Obamacare, but deep intra-party divisions have scuttled their efforts to get legislation through the Senate, where they hold a slim majority.

Since taking office in January, Trump threatened many times to cut the subsidies. Health insurers that planned to stay in the Obamacare market prepared for the move in many states by submitting two sets of premium rates to regulators: with and without the subsidies.

The National Association of Insurance Commissioners said the change would drive up premium costs for consumers by at least 12 to 15 percent in 2018 and cut more than $1 billion in payments to insurers for 2017.

The White House announced the cut-off just hours after Trump signed an order intended to allow insurers to sell lower-cost, bare-bones policies with limited benefits and consumer protections.

Republicans have called Obamacare an unnecessary government intrusion into the American healthcare system. Democrats have said the law needs some fixes but noted that it had brought insurance to 20 million people.

(Additional reporting by Lawrence Hurley, Justin Mitchell, Steve Holland, Makini Brice, Jeff Mason and Susan Heavey in Washington, Megan Davies in New York, Brendan O’Brien in Milwaukee, and Divya Grover in Bengaluru; Writing by Will Dunham; Editing by Lisa Von Ahn and Leslie Adler)

Trump scraps key Obamacare subsidies, urges Democrats to fix ‘broken mess’

Trump scraps key Obamacare subsidies, urges Democrats to fix 'broken mess'

By Yasmeen Abutaleb and Jeff Mason

WASHINGTON (Reuters) – U.S. President Donald Trump on Friday urged Democrats to make a healthcare deal after cutting off Obamacare subsidies to health insurance companies for low-income patients in a forceful move that sparked threats of legal action and concern of chaos in insurance markets.

“ObamaCare is a broken mess,” Trump tweeted early on Friday. “Piece by piece we will now begin the process of giving America the great HealthCare it deserves!”

The decision is the most dramatic action Trump has taken yet to weaken the Affordable Care Act, President Barack Obama’s signature healthcare law, which extended insurance to 20 million Americans.

The move drew swift condemnation from Democrats and threats from state attorneys general in New York and California to file lawsuits. Trump, a Republican, urged opponents to reach out to him.

“The Democrats ObamaCare is imploding. Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix!” Trump said in another tweet on Friday.

Trump has been frustrated by Republicans’ failure to repeal and replace the law known as Obamacare, thwarting a promise he made during his successful 2016 presidential campaign.

His decision is likely to please those among his political base who detest the Obamacare system, which many Republicans have attacked for years as an unneeded government intrusion in Americans’ healthcare.

In a nod to that same constituency, the president signed an executive order earlier on Thursday to make it easier for Americans to buy bare-bones health insurance plans exempt from Obamacare requirements.

Senate Democratic Leader Chuck Schumer and House Democratic Leader Nancy Pelosi derided the subsidies cut-off in a joint statement, saying Trump would single-handedly push Americans’ healthcare premiums higher.

“It is a spiteful act of vast, pointless sabotage leveled at working families and the middle class in every corner of America,” they said. “Make no mistake about it, Trump will try to blame the Affordable Care Act, but this will fall on his back and he will pay the price for it.”

Insurers and proponents of Obamacare have implored Trump for months to commit to making the payments, which are worth billions of dollars. Several insurers have cited uncertainty over the payments when hiking premiums for 2018 or exiting insurance markets altogether.

Healthcare stocks have edged lower in recent days. Ending the payments could hurt shares of insurers such as Anthem Inc, Molina Healthcare Inc, Cigna Corp and Centene Corp, which are offering plans on Obamacare markets for 2018.

Trump has made the payments, guaranteed to insurers under Obamacare to help lower out-of-pocket medical expenses for low-income consumers, each month since taking office in January. But he has repeatedly threatened to cut them off and disparaged them as a “bailout” for insurance companies.

For Kathryn Haydon and her husband, who bought insurance under the law’s marketplace three years ago as struggling college students in Arkansas, the subsidies reduced the cost of their $310 plan by about $250, leaving them to pay $60 each month.

“If the subsidy was not there, we would have gone without health insurance,” she said. “Our finances were extremely tight at the time for us… we would have just hoped there were no catastrophes.”

LAWSUITS

The White House said late on Thursday that it could not lawfully pay the subsidies anymore.

A White House statement said that based on guidance from the Justice Department, “the Department of Health and Human Services has concluded that there is no appropriation for cost-sharing reduction payments to insurance companies under Obamacare.”

“In light of this analysis, the Government cannot lawfully make the cost-sharing reduction payments,” it said.

New York Attorney General Eric T. Schneiderman said in a statement he was prepared to lead other attorneys general in a lawsuit.

“I will not allow President Trump to once again use New York families as political pawns in his dangerous, partisan campaign to eviscerate the Affordable Care Act at any cost,” he wrote.

The payments are the subject of a lawsuit brought by House Republicans against the Obama administration that alleged they were unlawful because they needed to be appropriated by Congress. A judge for the federal district court for the District of Columbia ruled in favor of the Republicans, and the Obama administration appealed the ruling.

The Trump administration took over the lawsuit and had delayed deciding whether to continue the Obama administration’s appeal or terminate the subsidies, but in April Trump began threatening to stop the payments.

That case became more complicated in August when a U.S. appeals court allowed 16 Democratic state attorneys general to defend the payments and have a say in the legal fight.

The political turbulence has affected insurers’ decisions.

Anthem Inc, one of the largest remaining Obamacare insurers, in August scaled back its offerings in Nevada and Georgia and blamed the moves in part on uncertainty over the payments.

Blue Cross and Blue Shield of North Carolina earlier this year raised premiums by more than 20 percent, but said it would have only raised premiums by about 9 percent if Trump agreed to fund the payments.

The nonpartisan Congressional Budget Office estimated that cutting off the payments would cause premiums to rise 20 percent in 2018, and that 5 percent of Americans would live in areas that do not have an insurer in the individual market in 2018.

Trump has taken other steps to undermine Obamacare. Last week, his administration allowed businesses and non-profit organizations to seek exemptions from Obamacare’s mandate that employers provide birth control in health insurance with no co-payment.

The administration also slashed the Obamacare advertising and outreach budget and halved the open enrollment period.

(Additional reporting by Steve Holland, Brendan O’Brien and Susan Heavey and; Editing by Michael Perry and Bernadette Baum)

Trump expected to sign order side-stepping Obamacare rules

FILE PHOTO: U.S. President Donald Trump calls on Republican Senators to move forward and vote on a healthcare bill to replace the Affordable Care Act, as people negatively affected by the law stand behind him, in the Blue Room of the White House in Washington, U.S., July 24, 2017. REUTERS/Joshua Roberts

By Yasmeen Abutaleb

WASHINGTON (Reuters) – President Donald Trump was expected to sign an executive order on Thursday that would make it easier for Americans to buy bare-bones health insurance plans and circumvent rules put in place by Obamacare, though such an order could face legal challenges.

Stymied in Congress by the failure of Senate Republicans to roll back former President Barack Obama’s 2010 healthcare law, Trump’s executive order would represent his administration’s latest effort to undermine the law without legislation.

The order would allow small businesses and individuals to band together as associations to buy cheaper health plans that would be exempt from some Obamacare requirements. Among the requirements would be the mandate that all health plans cover 10 essential health benefits, including maternity and newborn care, prescription drugs, and mental health and addiction treatment.

The order would also change an Obama-era limit on the time span people can use short-term health insurance plans, which are cheaper but cover few medical benefits. Trump was expected to order an extension for the period that long short-term insurance can be used to about a year, versus three months under Obamacare.

Republicans, despite having control of the White House and both chambers of Congress, have for months been unable to make good on their seven-year promise to repeal Obamacare, which they view as a government intrusion into Americans’ healthcare.

Experts questioned whether Trump has the legal authority to expand association health plans and whether some plans, but not others, could be exempt from Obamacare rules.

The action could open Trump to legal challenges from Democratic state attorneys general, who have said they will sue Trump if he tries to destroy Obamacare, a law that brought health insurance coverage to millions of Americans.

Experts said the association health plans could attract young, healthy people and leave a sicker, more expensive patient pool in the individual insurance markets created under the healthcare law, driving up premiums and effectively eroding the law’s protection for those with pre-existing conditions.

Conservative groups and lawmakers, including Republican Senator Rand Paul, who said he has worked with Trump for months on the expected order, and Republican Senator Ron Johnson, have cheered the expected order. Paul opposed the Senate’s most recent attempt to overhaul Obamacare because he said it left too many of Obamcare’s regulations and spending programs in place.

Trump has taken a number of steps since assuming power in January to weaken or undermine Obamacare. He has not committed to making billions of dollars of payments to insurers guaranteed under Obamacare, prompting many to exit the individual market or hike premiums for 2018.

The administration also halved the open enrollment period, which begins Nov. 1, and slashed the Obamacare advertising and outreach budget.

(Reporting by Yasmeen Abutaleb; Editing by Kevin Drawbaugh and Leslie Adler)

Trump says likely to sign new healthcare order this week

U.S. President Donald Trump meets with former U.S. Secretary of State Henry Kissinger in the Oval Office of the White House in Washington, U.S., October 10, 2017. REUTERS/Kevin Lamarque

WASHINGTON (Reuters) – President Donald Trump said on Tuesday he would sign a measure, likely this week, to allow people in the United States to buy healthcare across state lines.

“They’ll be able to buy, they’ll be able to cross state lines and they will get great competitive healthcare, and it will cost the United States nothing,” Trump told reporters in the Oval Office during a meeting with former Secretary of State Henry Kissinger.

“With Congress the way it is, I decided to take it upon myself, so we’ll be announcing that soon as far as the signing’s concerned, but it’s largely worked out,” he said.

Republicans in Congress have failed to make good on Trump’s campaign promise to repeal and replace the Affordable Care Act, President Barack Obama’s signature healthcare law, also known as Obamacare.

Trump has suggested before that he was eying an executive order that would allow individuals to purchase insurance across state lines through so-called health associations, which Republican Senator Rand Paul has advocated.

(Reporting by Jeff Mason; Editing by James Dalgleish)