President Donald Trump hinted that he may end a key Affordable Care Act subsidy that makes insurance accessible to poorer Americans, a move that may critically destabilize health-insurance exchanges.
The administration has previously floated the idea to halt subsidies that help insurers offset health care costs for low-income Americans, called a cost-sharing reduction subsidy, or CSR subsidy. In a tweet on Saturday, Trump hinted at ending that program.
"If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!" the president said in a tweet on Saturday.
It was unclear if Trump's message means he also plans to directly target subsidies that are available to health insurance policies for some Congressional staff members. Thousands of members of Congress and staff are enrolled in plans on the District of Columbia insurance exchange.
The White House declined to comment further on Trump's tweet.
A months-long effort by Senate Republicans to pass health care legislation collapsed early Friday after Republican John McCain of Arizona joined two of his colleagues to block a stripped-down Affordable Care Act change bill. McCain's "no" vote came after weeks of brinkmanship and after his dramatic return from cancer treatment to cast the 50th vote to start debate on the bill earlier in the week. The "skinny" repeal bill was defeated 49-51, falling just short of the 50 votes needed to advance it. Republicans Susan Collins of Maine and Lisa Murkowski of Alaska also voted against it.
Ending the CSR subsidies, paid monthly to insurers, is one way that Trump could hasten the current Affordable Care Act system's demise without legislation, by prompting more companies to raise premiums in the individual market or stop offering coverage. The administration last made a payment about a week ago for the previous 30 days, but hasn't made a long-term commitment.
Responding on Twitter, Andrew Slavitt, acting administrator of the Centers for Medicare and Medicaid Services in the Obama administration, said the impact of cutting off subsidy payments "will be felt by the middle class who will pay more to subsidize low income."
