Sarah Wasko / Media Matters

Trump ends cost-sharing reduction payments, calling them a “bailout” for the insurance industry

Trump ends cost-sharing reduction payments to insurance companies, calling them a “bailout.” President Donald Trump on October 12 said the government would stop issuing insurers cost-sharing reductions (CSR) payments, subsidies under the Affordable Care Act (ACA) that, as NPR reported, were “designed to help low-income Americans get health care.” In a statement, the White House called the payments a “bailout of insurance companies.” [NPR, 10/12/17]

Trump decries bipartisan deal to shore up health insurance markets for “bailing out” insurers. After Senate leaders reached a bipartisan deal to shore up insurance markets with legislation to reinstate CSR payments for a short time period, Trump tweeted, “I can never support bailing out [insurance companies] who have made a fortune” with the ACA. [NPR, 10/17/17]

Trump had also called the payments “BAILOUTS for Insurance Companies” in a July tweet:

If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!

— Donald J. Trump (@realDonaldTrump) July 29, 2017

CSR payments are not a “bailout” to insurers

NY Times: CSR payments “are more accurately characterized as a reimbursement that the government pays to insurance companies.” The New York Times pointed out that calling CSR payments “‘a bailout’ is misleading,” noting that they “are more accurately characterized as a reimbursement that the government pays to the insurance companies.” The paper added, “It is done not to save the companies from financial ruin — unlike the banks in 2008, they are not in danger of failing — but to cover the cost of cheaper health care for low- and moderate-income Americans.” From the October 18 New York Times article:

“Bailout” typically refers to financial assistance offered to prevent the bankruptcy of a company or industry. The 2008 Troubled Asset Relief Program (which Mr. Trump largely supported) was a bailout because it provided $700 billion for the Treasury Department to buy troubled securities from banks that were at risk of collapse.

The funds Mr. Trump now refers to, on the other hand, are more accurately characterized as a reimbursement that the government pays to the insurance companies. It is done not to save the companies from financial ruin — unlike the banks in 2008, they are not in danger of failing — but to cover the cost of cheaper health care for low- and moderate-income Americans. [The New York Times, 10/18/17]

Wash. Post: “Trump is misusing the term ‘bailout.’” The Washington Post’s Fact Checker gave Trump “Four Pinocchios” for his July 29 tweet, writing, “President Trump is misusing the term ‘bailout.’” The Fact Checker pointed out that “Insurance companies don’t make money through cost-sharing — they are being paid back for money they’ve already spent on behalf of people who purchased their health plans.” [The Washington Post, 8/7/17]

Right-wing media have repeatedly referred to CSR payments as “bailouts” for the insurance industry

Fox’s Ainsley Earhardt: “Our tax dollars have been bailing out these insurance companies.” When discussing CSR payments, Fox & Friends co-host Ainsley Earhardt alleged that “our tax dollars have been bailing out these companies.” Co-host Steve Doocy also called the subsidies a “bailout for the insurance companies.” From the October 13 edition of Fox News’ Fox & Friends:

BRIAN KILMEADE (CO-HOST): By the way, if anyone was fearful on Friday the 13 of Obamacare imploding, that was doing it on its own, but the president is actually taking action and is pretty much fed up with what’s been going on. So last night around 9 o'clock, he had his second shot at taking it out.

AINSLEY EARHARDT (CO-HOST): The first shot, he signed [an] executive order encouraging competition, more choices, lower cost. And then he stopped the bailouts to the insurance companies.

KILMEADE: Which is about $7 billion.

[...]

STEVE DOOCY (CO-HOST): What [Trump’s] talking about is the administration has been propping up the insurance companies that take part for, as Brian just mentioned, $7 billion a year. Essentially what it's going to do, it’s going to end the payments. And here's the reason why this makes sense, because they were never approved. When they carved up the law of Obamacare, they never said, “OK, and then there’s going to be this bailout for the insurance companies.” In 2014, the Republican Party sued the federal government. In 2016, a federal judge said, “You know what? The Republicans are right, those payments are improper.”

EARHARDT: So because the government, our tax dollars, have been bailing out these companies, they’re able to stay in Obamacare. [Fox News, Fox & Friends, 10/13/17]

Conservative Review’s Daniel Horowitz: Funding CSR payments is “bailing out the insurance cartel.” Daniel Horowitz, a senior editor at Conservative Review, blasted CSR payments during an appearance on One America News’ The Daily Ledger, claiming that funding them is “bailing out the insurance cartel.” Host Graham Ledger made similar remarks, calling CSR payments “a payoff for the participation of the insurance companies” and “a bribe.” From the October 18 edition of One America News’ The Daily Ledger:

GRAHAM LEDGER (HOST): We have [Sen.] Lamar Alexander [(R-TN)] come along, and he’s saying we'll now just make what is unconstitutional -- and by unconstitutional, I don’t mean just the entire law; I mean the subsidy component. This was not appropriated by Congress. Obama just simply took this money, and has been giving it, and I call it a payoff for the participation of the insurance companies. It's a bribe. He’s been just giving it, and then the Republicans have continued giving it to the insurance companies. So we have two tracks here, two competing tracks that really is kind of mind-boggling when you try and piece it together.

DANIEL HOROWITZ: Think about how Orwellian this is. Republicans, during the last number of years, ran on two things: no Obamacare, no bailouts. Now they're bailing out the insurance cartel and the people that burned down health care in America over the years long before Obamacare. [One America News, The Daily Ledger, 10/18/17]

CNN’s Stephen Moore: CSR payments are “a bailout of the insurance companies.” When asked about Trump’s characterization of the subsidies, CNN contributor and former Trump campaign adviser Stephen Moore agreed with the president, calling CSR payments “a bailout of the insurance companies.” [CNN, Erin Burnett OutFront, 10/13/17]

Fox Business’ Ashley Webster: “You could argue that the subsidies to the insurance companies was a bailout.” Fox Business’ Ashley Webster claimed that “the subsidies to the insurance companies was a bailout, as Mr. Trump has stated.” [Fox Business, Varney & Co., 10/16/17]

Frequent Fox guest Dan Bongino: CSR payments are a “taxpayer-funded bailout of the health insurance companies.” Frequent Fox guest and talk radio host Dan Bongino asserted that CSR payments are a “taxpayer-funded bailout of the health insurance companies.” [Fox News, Justice with Judge Jeanine, 10/14/17]

Fox Business’ Liz Claman: CSR payments are “bailout cash going to the insurers.” Fox Business host Liz Claman referred to CSR payments as “bailout cash going to the insurers.” [Fox Business, Risk and Reward with Deirdre Bolton, 10/13/17]

Townhall: Bipartisan compromise on ACA includes “new bailouts of insurance companies.” In a piece for Townhall, Brian Darling wrote that the bipartisan compromise to shore up ACA markets includes “new bailouts of insurance companies,” referring to a provision to reinstate CSR payments. [Townhall, 10/18/17; CNN, 10/17/17]

Gateway Pundit: Trump blocked “Obamacare insurance bailouts.” The Gateway Pundit lashed out at Sen. Susan Collins (R-ME) after she “attacked President Trump for his actions to block Obamacare insurance bailouts.” [The Gateway Pundit, 10/15/17]

NY Post’s F.H. Buckley: Trump halted the “bailout” to insurers. New York Post columnist F.H. Buckley said that by ending CSR payments, Trump had halted “the bailout” to insurers. [New York Post, 10/13/17]

No Bailouts- @realDonaldTrump puts #AmericaFirst, rejects bailout for health insurers. @RepDeSantis Joins #Dobbs on FBN7p #MAGA #TrumpTrain

— Lou Dobbs (@LouDobbs) October 18, 2017

Ending CSR payments would increase some premiums, cost the government more, and possibly push insurers out of exchanges

HealthAffairs.org: Without CSR payments, “some insurers might well decide that the government is an unreliable partner and give up on the exchanges for 2018.” HealthAffairs.org contributing editor and consumer liaison representative to the National Association of Insurance Commissioners Timothy Jost explained that if the government were to withhold CSR payments, “some insurers might well decide that the government is an unreliable partner and give up on the exchanges for 2018.” [HealthAffairs.org, 8/2/17]

CBO: If the government were to withhold CSR payments, premiums for some plans “would, on average, rise by about 20 percent in 2018.” In an August analysis, the nonpartisan Congressional Budget Office (CBO) estimated that without CSR payments, premiums for some plans would “rise by about 20 percent in 2018” compared to current projections. Additionally, the CBO found that premiums would “rise slightly more in later years” without CSR payments. [Congressional Budget Office, August 2017]

Kaiser Family Foundation: Ending CSR payments “would result in a net increase in federal costs of $2.3 billion” in the next year. An analysis by the Kaiser Family Foundation found that ending CSR payments for the fiscal year “would result in a net increase in federal costs of $2.3 billion” compared to current projections. Additionally, in 10 years, “the federal government would end up spending $31 billion more if the payments end.” [Kaiser Family Foundation, 4/25/17]