The Trump administration official spoke to about 20 journalists on Wednesday on the condition of anonymity, evidently because major decisions had not been made. The fifth annual open enrollment period, when people can sign up for insurance or switch plans, will run from Nov. 1 to Dec. 15, about half as long as the last one.
Asked if the Trump administration wanted the public marketplaces to succeed, the official did not answer directly.
“We want people to have access to quality health care,” the official said. “I look at it from a patient perspective. I’m a mom. I’ve got two kids. I’ve got a family. I try to look at health care through that lens. What would I want? What would my family want? I think people want stability in the marketplace.”
“We want the health care market, the individual marketplace to function and to function well,” the official added. “It is not functioning, the way it is today.”
In early September last year, the Obama administration awarded $63 million in grants to “navigators” to help consumers enroll in coverage through the federal insurance marketplace. The Trump administration official declined to say how much it might award.
The official said the administration was assessing the effectiveness of the navigator program and similar assistance efforts.
“What we’re seeing with some of the programs is you’re spending a lot of money on it, but the idea of these programs is to sign people up,” the official said. “And if you’re giving them a grant and they’re only signing up a few people, then we’re actually wasting money there when we’re spending thousands of dollars to sign up one person. That doesn’t make any sense.”
When asked if the administration would continue paying the subsidies to insurance companies to aid low-income people, the official said that “you still had double-digit rate increases” when the Obama administration provided the subsidies, known as cost-sharing reduction payments.
Members of Congress from both parties say they want to provide money for the subsidies, which Mr. Trump has repeatedly threatened to cut off.
The Trump administration official did say the administration wanted Congress to provide money to continue the Children’s Health Insurance Program, which was created in 1997 with bipartisan support. Some states will exhaust their allotments of federal money soon after the federal fiscal year ends on Sept. 30.
In addition, the official said that “we are really worried” about a recent trend: the consolidation of health care providers in many markets in the past few years.
Doctors practicing alone or in small groups cannot cope with the ever-increasing burden of federal rules and requirements, the official said, adding: “They are being bought out by large hospital systems. So then what we have is just a large hospital system, and there’s not competition in the marketplace. That actually can reduce quality in the system.”
In a number of recent antitrust cases, hospitals have argued — with mixed success — that by banding together with doctors, they can improve care for patients.
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