The Role of Eleventh Hour Insurance Exchange Reimbursement Payments

If it is true that the Trump Administration intends to let the ACA collapse of its own weight, then it is time — while attempting to breathe life again into the moribund BCRA — to preview for the American Public what that brave new world would look like.

Time to stop making month by month, day by day, minute by minute cliff hanger decisions on whether to continue to fund payments to stabilize insurance insurance markets while pretending doing things  exactly this way does not, in fact, drive insurers out of the exchanges. Turns out insurers don't plan exchange and market participation on a day by day basis. This makes it possible to undermine the exchanges while claiming not to have done anything.

Of course, this would not be letting the ACA fail out of whole cloth, it would be affirmatively taking action to undermine it further in a crucial way. So, show your hand and explain why you think this is good for the American people if you believe it is.  If you take the position that Congress has the discretion to fund these payments, please explain the choice to continue to fund these payments at the ACA level rather than at the BCRA (differing versions) levels.  In short, explain yourself. 

The quality of the public discourse on the latest iteration of the BCRA would be increased by a bit more candor as to machinations already underway behind the scenes in insurance markets. And, sadly, it might be improved, by increased public understanding of just how tenuous a grasp many millions of Americans have on exchange purchase subsidy payments.