Insurers, providers decry Trump's threat to stop payment to insurers

Overriding assurances by House Speaker Paul Ryan and in a move to strong-arm Democrats to negotiate on a new healthcare plan, President Donald Trump has threatened to stop cost-sharing reduction payments to insurers put in place under the Affordable Care Act.

Trump told the Wall Street Journal that his administration may not have the legal authority to continue making the payments to insurers.

"It wasn't authorized by Congress. I'm going to have to make a decision," Trump told the WSJ. "Obamacare is dead next month if it doesn't get that money. I haven't made my viewpoint clear yet. I don't want people to get hurt. ...What I think should happen and will happen is the Democrats will start calling me and negotiating."

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The president has the authority to pull the plug on the payments by dropping an appeal on the cost-sharing reduction reimbursements brought by a Democratic administration.

Democratic leaders Sen. Chuck Schumer of New York and Rep. Nancy Pelosi of California have reportedly said they are unwilling to discuss a deal with Trump while the prospect of undermining the law remains on the table.

The U.S. Chamber of Commerce joined letters to the president and Congress signed by healthcare groups including America's Health Insurance Plans, the American Hospital Association and the American Medical Association, urging them to stabilize the individual market for 2017 and 2018 by removing the uncertainty about continued funding for the cost-sharing reductions.

More than 7 million people in the ACA marketplaces, or 58 percent, currently receive the benefit of the cost-sharing reductions.

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"Without CSRs, health care coverage will be out of reach for them," AHIP said on its website. "Plans will likely drop out of the market. Premiums will go up for everyone. Costs will go up for taxpayers. And doctors and hospitals, foundational to their communities, will see even greater strains on their ability to care for people."

If Trump follows through on his threat, silver plans in the Affordable Care Act marketplaces would be expected to increase by an average 19 percent, according to a study by the Kaiser Family Foundation.

This is because insurers would have to increase premiums to make up for the lack of reimbursement from the federal government for reducing deductibles for lower-income beneficiaries.

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In 2016, a federal judge ruled in favor of a lawsuit brought by Republican leaders who said Congress never appropriated the money for the CSR payments. The payments continued while the Obama administration pursued an appeal.

After the election of Donald Trump, Republicans requested and received delays in the case. These delays would expected to be dropped after Trump and the GOP fulfilled their promise to repeal and replace the Affordable Care Act.

The House is expected to soon vote on an amendment to House Speaker Paul Ryan's proposed American Health Care Act, after Ryan pulled the AHCA bill in March for lack of support from conservative members of his party.

However, Ryan made assurances of continuing the cost-sharing reduction funding while the GOP hammered out a new plan.

Twitter: @SusanJMorse