Minneapolis Star Tribune, July 13
Trump administration takes aim at Affordable Care Act, but harms private insurance market instead
Destabilizing private market hurts consumers, will hasten push for more government involvement.
The United States’ reliance on private health insurers and medical providers sets it apart from the rest of the developed world, where government has a much heavier hand in health care.
Those who want to keep that independence should be strengthening the private sector’s ability to deliver affordable coverage. Instead, the Trump administration is doing just the opposite. It is sabotaging the private insurance market, harming consumers in the process, as it escalates its death-by-1,000-cuts attack on the Affordable Care Act (ACA).
With insufficient congressional votes to repeal former President Barack Obama’s signature law, the mission to unravel it has fallen to the president’s appointees running key federal health agencies. They have weakened the law in myriad ways. Among them: pushing the sale of skimpy health plans that would siphon healthy people out of the insurance market and drive up the cost of comprehensive coverage for those who need it. Another strategy: shutting down the healthcare.gov website during peak times when consumers needed to access it to buy health insurance.
The latest targeting of the law gets into health policy weeds but merits a spotlight because it’s a sneaky way to further undermine the private insurance market and, by extension, the ACA. On July 7, the federal Centers for Medicare and Medicaid Services abruptly announced that it plans to halt or delay $10.4 billion in “risk adjustment” payments between insurers selling plans in the individual health insurance market. This is where people who don’t get coverage through an employer or a government program such as Medicare typically buy coverage.
The risk adjustment program, which doesn’t use taxpayer dollars, is a long-established mechanism to spread risk and promote market stability. Health plans that wind up with healthier and less-expensive enrollees transfer funds to insurers with disproportionately sick and costly-to-care-for patients. Consumers benefit because this program helps keep premium prices down, discourages insurers from cherry-picking healthy customers and entices firms to compete in the small, volatile individual market.
Tinkering with these payments means that some insurers will not get the funds they were counting on, while others will get to keep money they would have paid out. The sums involved could be substantial, with three Minnesota insurers potentially taking a $71.7 million financial hit, according to Star Tribune reporter Chris Snowbeck’s analysis. The trade industry group America’s Health Insurance Plans has warned that halting the payments will “increase premiums” while “reducing coverage options.”
While federal officials have said that they had to suspend the risk adjustment program because of a court case, legal experts have criticized the move as unnecessary. Coming on the heels of other moves to destabilize the market, suspicion of the administration’s motives is justified.
Federal officials did announce late Thursday measures that appear to somewhat soften the blow of their decision. Nevertheless, they’ve still added to insurers’ uncertainty about market stability.
Unintended consequences should give pause to those working to weaken the ACA. If the individual insurance market becomes unworkable, alternatives will more than likely include heavier involvement by the government.
“Everything that Trump and the GOP do to undermine the ACA increases the chances of single-payer insurance,” said Ezra Golberstein, a University of Minnesota associate professor in health policy and management. “Moderate Dems who like private-sector solutions will reasonably conclude they have no good-faith partners in the GOP who understand insurance markets.”
Many, including ACA defenders, will view more government involvement as an improvement and embrace the chance to make it a reality. The ACA’s critics will not, but when they’ve done everything possible to subvert the private sector’s role in ACA reforms, they shouldn’t wonder why that moment has come.
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The Free Press of Mankato, July 14
Ag and rural areas must fight Trump
Why it matters: Imposition of Chinese tariffs on U.S. pork and soybeans will have negative impacts on prices and farm income.
The Mankato area is set to be stung particularly hard by President Donald Trump’s game of chicken with China as they impose tit-for-tat tariffs on a number of goods significant to the region’s economy.
Soybeans and pork are likely to be hit the hardest. Blue Earth County and the surrounding seven counties are the top producing counties in Minnesota for these products. The raw materials are tied to a number of other industries in the region, including ag processing, ag finance and agribusiness consulting.
There is no shortage of experts on both sides of the political aisle who warn against Trump’s strategy. The president tweeted to farmers on Wednesday saying he would help them sell their products, but it might take a while.
“I will open things up, better than ever before, but it can’t go too quickly,” he tweeted.
Even members of his own party say the trade wars are hurting agriculture prices already.
Sen. Charles Grassley, R-Iowa, told Fox News: “I’m very, very nervous about it, and my constituents are very, very nervous about it.
“I hope he knows what he’s doing,” Grassley told Fox, referencing Trump’s trade war strategy.
That’s the point. Trump doesn’t know what he’s doing. Republicans who represent rural America across the country need to stand up and tell him that.
Trump’s bravado on trade has been rippling through the markets. His former top economic adviser says uncertainty among business on trade could completely undo the impact of corporate tax cuts. Experts who watch capital spending say businesses are not spending more, even though they got huge tax breaks, because they fear they’ll lose their overseas business.
It’s not surprising Trump is weak on trade thinking. He made his millions on real estate in New York, not corn in Iowa. He knows how to bluster at competing developers but knows little about selling tons of soybean meal to Chinese livestock producers.
Trump’s recent attitude that “it will take a while” suggests his other trade deals can be balanced on the backs of farmers, who can wait for their income.
Agricultural and rural America, which voted for Trump, needs to make clear he’s damaging their interests and thwarting their livelihoods.
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Post Bulletin, July 16
UMR will lose a champion when Kaler goes
The University of Minnesota Rochester has been around for about 12 years.
Eric Kaler has been president of the University of Minnesota for seven of those years and has championed the innovative (read: experimental) Rochester campus throughout his tenure.
There have been lean years for UMR enrollment and more promising years; it appears to be in growth mode now. It’s a tiny project, just a speck on Goldy Gopher’s back amid the totality of what the University of Minnesota is about. Systemwide, it has 44,500 students, about 71 percent of them in the Twin Cities. Rochester has fewer than a thousand students. It was only five years ago that it produced its first graduating class.
Though plans are in the works for building a campus, a master plan for the U of M that’s in the final phase of drafting calls for only modest enrollment growth here.
So Kaler’s announcement Friday that he plans to retire at the end of the 2018-19 year is reason to look ahead as well as appreciate his contributions. The U of M has enjoyed a period of moderate growth, fiscal restraint and refocusing of mission during his tenure. He’s proven to be a prodigious fundraiser and he’ll continue that for a year after he steps down on July 1 next year.
There have been personnel debacles along the way, including the departure of former Athletic Director Norwood Teague in 2015 amid sexual harassment allegations, and Kaler has had his critics at the Capitol. As he said Friday, “my tenure already exceeds the national average,” which says as much about the fraught demands of the top job at a major university as it does about Kaler.
“This is an incredibly demanding job … and as proud and confident of my contributions and ability as I am, I also know that the University will benefit from a fresh perspective.”
This is always true, in every line of work. But it likely will give UMR boosters in Rochester reason for pause as well. UMR has a new chancellor, Lori Carrell, who took over in February from the founding chancellor, Stephen Lehmkuhle, who shaped the mission and vision for the branch campus.
Carrell clearly is committed to and energized by that mission, and Kaler and the Board of Regents remain committed and engaged. Though Rochester isn’t represented on the board for the first time in many years, the Regents met in Rochester in March and expressed support for what’s happening here. UMR recently confirmed that it will lease space in One Discovery Square, the Destination Medical Center building going up on Second Avenue Southwest, and preliminary work continues in the area where UMR hopes to develop a campus.
Still, if change at the top gives a “fresh perspective,” it also means UMR and every other unit of the University will need to make a fresh, persuasive case for what they do, how it contributes to the broader institutional mission and also how it makes sense for the bottom line.
Rochester and UMR have a great case to make to whoever takes over Kaler’s chair in Morrill Hall. It’s not too early to start thinking that through.
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