Trump health chief: Premiums to drop for popular ACA plan

Premiums for a popular type of "silver" health plan under the Affordable Care Act will edge downward next year in most states, the Trump administration's health chief announced Thursday.

Health and Human Services Secretary Alex Azar said premiums for a so-called "benchmark" silver plan will drop by 2 percent in the 39 states served by the federal HealthCare.gov website.

The number of marketplace insurers will grow for the first time since 2015, he added.

Azar's numbers were in line with a broader independent analysis earlier this month by Avalere Health and The Associated Press, which found premiums and markets stabilizing nationwide. But his claim that the Trump administration deserves credit for Obamacare's turnabout was quickly challenged.

"The president who was supposedly trying to sabotage the Affordable Care Act has proven better at managing it than the president who wrote the law," Azar bragged in his speech to a health policy group in Nashville. Azar cited regulatory actions to improve the inner workings of the ACA marketplaces and increase consumer choice among insurance plans that don't comply with health law rules.

The earlier AP analysis had found that average premiums across all types of plans under the Obama health law will rise 3.3 percent, with 12 states seeing declines. That study crunched data from 47 states and Washington, D.C., with publicly available information on proposed and final rates for 2019.

Reacting to Azar's claims, Larry Levitt of the nonpartisan Kaiser Family Foundation said it's likely that premiums for 2019 would have gone down even more but for other administration actions last year that roiled the markets.

Those included President Donald Trump's abrupt cancellation of a major stream of payments to insurers—which triggered sharp 2018 premium increases. Also, Trump and congressional Republicans spent much of last year in a fruitless quest to repeal "Obamacare," with the president repeatedly pronouncing it "dead."

"The premium stability on tap for 2019 is primarily because insurers overshot with their premium increases for this year, reacting to an environment of tremendous uncertainty," Levitt said.

Under the design of the ACA, premium increases automatically boost taxpayer-provided subsidies to consumers. Big premium increases last year allowed many insurers to return to profitability as subsidies flowed from federal coffers. The average total premium for an individual covered under the health law is now close to $600 a month.

In previous election years, health law premiums have provided plenty of material for Republican attack ads. That issue has been taken away this year by market stability. Instead the debate has shifted to Democratic charges that the Trump administration and Republicans want to undermine the ACA's protections for people with pre-existing health conditions.

Azar's speech also took aim at the "Medicare for All" national health plan sought by Sen. Bernie Sanders, saying it would undermine access for seniors and pile huge costs on taxpayers.

The Trump administration is stepping up its criticism of the Vermont senator's plan as many Democratic candidates in the midterm elections voice support for his vision of a government-run health care system.

"The main thrust of 'Medicare for All' is giving you a new government plan and taking away your other choices," Azar said.

As proposed, the Sanders plan would cover all Americans. Taxes on individuals and employers would replace premiums, deductibles and copays, and the government would set payment rates for hospitals and doctors.

Sanders says his approach would uphold quality and gradually bring costs under control, but studies show it would translate to a historic expansion of the federal government's role in health care. Critics doubt promised savings could be delivered.