President Donald Trump personally told a top federal health official to reject Iowa’s pending request to try to stabilize its individual insurance market with a waiver from Obamacare rules, according to a new report.
And a leading Obamacare expert now says that Trump’s reported call seems to be part of a broader effort to actually drive up prices of Obamacare health plans so as to “undermine” the Affordable Care Act.
The new Washington Post article said that Trump in late August called Seema Verma, the administrator for the Centers for Medicare and Medicaid Services, after seeing a Wall Street Journal story detailing Iowa’s so-called 1332 waiver request.
That waiver request was being pushed by Iowa’s Republican governor, Kim Reynolds, who in an Aug. 21 letter to Verma’s then boss, Dr. Tom Price, said, “We face an immediate collapsing [individual insurance] market that could leave thousands without health insurance and the rest with 56 [percent] or higher premium rate increases.”
Both of Iowa’s senators, Republicans Chuck Grassley and Joni Ernst, also wrote Price and Verma to ask them to give the waiver request “all due consideration,” as they also said state residents “are facing an unaffordable and unstable individual health insurance market.”
Despite those urgent requests, the Post reported that Trump’s “message” to Verma was clear “according to individuals who spoke on the condition of anonymity to discuss private conversations: Tell Iowa no.”
The Post report comes a week after Oklahoma’s health commissioner wrote a letter to Price and Treasury Secretary Steven Mnuchin criticizing the Trump administration for having missed the Sept. 25 deadline for approving that state’s own request for a 1332 waiver from Obamacare rules next year to stabilize the insurance market there. Like Iowa, Oklahoma is led by Republicans.
“The lack of a timely waiver approval will prevent thousands of Oklahomans from realizing the benefits of significantly lower insurance premiums in 2018,” wrote Terry Cline, the health commissioner.
A White House spokesman declined to comment on the Post’s story about Trump’s call to Verma when contacted by CNBC.
But the spokesman said that all decisions about waiver requests such as Iowa’s, which remains pending, “will be made by the secretary of HHS,” the U.S. Health and Human Services Department.
Price, who had held that job, resigned Sept. 29 after revelations that his use of private planes and military jets had cost taxpayers more than $1 million this year. HHS is currently run by acting Secretary Don White.
CNBC has reached out for comment from spokesmen for CMS, which is a division of the Health and Human Services Department, and from the press office of HHS itself.
Tim Jost, a law professor and Obamacare expert, in a Health Affairs blog post Friday, wrote that Trump’s reported call to Verma “appears to be part of a larger strategy to drive up premiums for [Affordable Care Act]-compliant health plans to undermine the ACA.”
“It is unclear whether this will end the Iowa waiver process, which in any event faced an unrealistic implementation schedule to be in place by the launch of the 2018 open enrollment period in less than a month,” Jost wrote.
Iowa on Thursday submitted to CMS a supplement to the Iowa Stopgap Measure.
The overall request proposes scrapping Iowa’s Obamacare marketplace, and replacing it with a “single, standard” health plan available to every eligible state resident from each participating insurer.
It also proposes offering a flat subsidy, based on age and income, to help low- and middle-income people pay for their insurance. That would replace current Obamacare subsidies which are based on the cost of a plan, as well as on income.
The request also proposes setting up a reinsurance program that would support people who had high levels of medical costs.
A spokeswoman for Reynolds, Brenna Smith, told CNBC that the governor’s office and the Iowa Insurance Division “are in constant communication with the White House and CMS, seeking approval on our state’s Stopgap Measure,” which would “ensure 72,000 Iowa farmers and small business owners have access to affordable health insurance in 2018.”
“The federal government recently deemed Iowa’s Stopgap Measure application complete and is currently conducting a 30 day public comment period that ends October 19,” Smith said. “We are working with the White House and CMS to approve Iowa’s Stopgap Measure in a timely manner to relieve 72,000 suffering Iowans from Obamacare.”