Apr 28, 2019

Trump plans to formally give up on part of the Affordable Care Act

Photo: Mark Wilson/Getty Images

The Trump administration is about to formally give up on a part of the Affordable Care Act that had largely died on its own.

Driving the news: The Office of Personnel Management intends to stop administering the ACA’s multi-state insurance plans. Axios reviewed a draft of the notification letter OPM is planning to send to congressional leaders.

How it works: The ACA initially envisioned creating 2 multi-state plans — private insurance policies that would be available through the ACA’s insurance exchanges in every state. The goal was to provide guaranteed competition in states that lacked it.

  • But the policy never got off the ground. By 2017, there was just 1 plan operating in just 1 state: a Blue Cross Blue Shield plan in Arkansas.
  • OPM will tell Arkansas Blue Cross Blue Shield thanks for its cooperation, but then shutter the multi-state effort, according to the draft letter.

Between the lines: An administration official framed the death of the multi-state plans as a bad omen for "Medicare for All," arguing that it was “a pilot program for the public option, and it’s been a dismal failure with even the most liberal states balking on it.”

  • It’s true that this policy was designed to do some of the same things a public option would have done, and that it failed.
  • But it failed, in part, because its insurers never were very enthusiastic about setting up networks of doctors and hospitals across multiple states — which is also a bad omen for the conservative priority of selling insurance across state lines.

The bottom line: “I've always sort of felt like it was well-intentioned but not reflective of the right reality of what's limiting competition," Georgetown University health policy professor Sabrina Corlette told Axios back in 2017.

Go deeper

America's unfinished business

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The fury over George Floyd's killing is erupting as the U.S. faces a looming wave of business bankruptcies, likely home evictions and a virus pandemic that will all disproportionately hit African Americans.

Why it matters: What these seemingly disparate issues share in common is that they emanate from systemic abuses that calls to action and promised reforms have yet to meaningfully address.

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  3. Supreme Court: Chief Justice Roberts sides with liberals in denying challenge to California's pandemic worship rules.
  4. Public health: Hydroxychloroquine prescription fills exploded in March.
  5. 2020: North Carolina asks RNC if convention will honor Trump's wish for no masks or social distancing.
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Deaths without consequences

Community organizations and activists demand police accountability at a rally in Grand Central Terminal to commemorate the 5-year anniversary of Mike Brown's death by Ferguson Police Officer Darren Wilson. Photo: Erik McGregor/Getty Images

Seven years after the launch of the Black Lives Matter movement, it's still rare for police officers to be charged in the deaths of African Americans — and even more rare for an officer to go to jail.

The big picture: The Minneapolis police officer who was captured on video kneeling on George Floyd's neck has been charged with third-degree murder and manslaughter — which is already a step beyond the consequences other police officers have faced. But it's no guarantee that he will face jail time.