JUDY WOODRUFF: The president’s decision to
stop paying subsidies to health insurers was his second direct blow in one day at the law
that has come to be known as Obamacare. The payments are made directly to insurance
companies, which, in turn, use that money to reduce costs for lower-income Americans. The money helps pay for deductibles, for co-payments
and out-of-pocket charges. Depending on a individual’s income level,
the subsidies have lowered costs by, on average, $1,000 a person, but they can range anywhere
from $700 to more than $3,300 a person. The subsidies were first challenged by a lawsuit
from congressional Republicans in 2014. A federal judge agreed, pointing out that
the money had not been formally appropriated by Congress. Still, payments have continued while this
legal case was being appealed. Julie Rovner of Kaiser Health News joins me
now to look at what the president’s move means. Julie, welcome back to the program. JULIE ROVNER, Kaiser Health News: Nice to
be here. JUDY WOODRUFF: So, just remind us, clarify
for us who, what was getting these subsidies and why. JULIE ROVNER: Well, there are two kinds of
subsidies in the Affordable Care Act. People up to four times poverty level get
help paying their premiums. But for people who are up to 2.5 times the
poverty level — it’s about $30,000 for an individual — they get — in addition to the
help paying the premiums, they get these helps for out-of-pocket costs, on the theory that,
even if they could afford the premium, they might not be able to afford to go and actually
get coverage. It’s about seven million people of the roughly
10 million people who buy on the health insurance exchanges. So, it’s a majority of those people, and actually
they will continue to get these subsidies. JUDY WOODRUFF: But you were saying to me a
little while ago, it’s important to point out, again, when you say 400 percent of the
poverty level, these are people who are earning in a range of what around the country? JULIE ROVNER: For a couple, it’s about $64,000. Those are the people who are getting help
with their premiums. To get help with these cost-sharing subsidies,
you would have to learn substantially less. Per couple, it would be about $40,000. JUDY WOODRUFF: So, let’s talk about the potential
impact here. What about first on the health insurance companies? JULIE ROVNER: Well, this is where it’s really
going to come home, that, right now, the insurance companies are required under their contracts
and by the law to provide these subsidies to these low-income people, to provide the
cost-sharing subsidies. There’s the questions, as we have seen with
the lawsuit, about whether or not Congress formally appropriated the money, but, as many
lawyers have pointed out, the fact — whether or not Congress appropriated it, the law says
the insurance companies will provide it to the individuals, and that the federal government
will pay back the insurance companies. So it’s money that’s owed. Congress — the easy way to solve it would
be for Congress to appropriate the money. JUDY WOODRUFF: And these insurance companies
— there is some dispute about what that means for these insurance companies. JULIE ROVNER: That’s right. Well, there’s a number of things the insurance
companies can do. The president telegraphed from the very beginning
of his administration that he might stop paying these. For a while, it was every month we were sort
of waiting to see, would he pay them the next month? For a while, he was paying them, waiting to
see if Congress was actually going to repeal and replace the Affordable Care Act. And they didn’t. And so companies have mostly built into their
premiums for next year. Remember, open enrollment starts in about
two-and-a-half weeks — they have built in not getting these subsidies. But it’s not true of every company. It’s not true of every state. So it’s going to be a very mixed bag. They can also sue. They can go to court and say, you owe us this
money. And they might be able to get it. And others have sued on their behalf. JUDY WOODRUFF: So, that’s something that is
out there and we can’t predict at this moment. So, consumers, bottom line, Julie, what does
this mean for people who have been receiving these benefits? JULIE ROVNER: Well, there is a lot of confusion
about this. Not paying the subsidies, as the president
pointed out, doesn’t mean that the people who are getting them now won’t get them. If insurance companies pull out — and they
can do that — that’s in most of their contracts that if these don’t get paid, they can pull
out — then nobody would get coverage. But if insurers stay, then the people who
are getting the subsidies will continue to get them. The people who will pay are the people who
aren’t getting help paying their premiums, the people who earn more than four times the
poverty line. It’s about another — a different seven million
people. They will be basically asked to pay these
entire premium increases, because they’re not getting help. JUDY WOODRUFF: I think that’s an outcome of
this that I think a lot of people have not focused on. So, let’s talk about the cost to the government. I mean, on its face, you would think, oh,
well, they’re stopping the subsidies; that means the government is going to save a lot
of money. But you were telling us it’s not that simple. JULIE ROVNER: No. What’s ironic is that this will cost the federal
government more money, according to the Congressional Budget Office, because what happens is that
insurers will raise their premiums. When they raise premiums, remember, the premium
subsidy comes in. Those premium subsidies will go up to match
the increases in premiums. So people who are getting help won’t see these
increases. As I just mentioned, the people who aren’t
getting help, the people who are paying their entire premiums themselves, they will be asked
to pay more. But the government will also be asked to pay
more. JUDY WOODRUFF: Julie, stepping back, look
at the overall health care marketplace. How much is this expected to impact that? JULIE ROVNER: Well, this — it’s a relatively
small piece. It’s about 17 million people in the individual
market out of, what, 330 million Americans. But even people who represent employer plans
were complaining today that this could end up affecting them. If there are fewer people with insurance or
people who couldn’t pay their out-of-pocket costs, that that — that providers would pass
those along to people with employer insurance, that there are ways that this could have a
ripple effect, probably not a big one. But it could impact the rest of the health
insurance market. JUDY WOODRUFF: And, finally, the president’s
done this. I mean, he’s made this move. Could Congress in any way step in and change… JULIE ROVNER: Absolutely. All Congress needs to do is appropriate the
money. And there’s been discussions in Congress really
since the last repeal and replace failed to do that, to pay that money for a couple of
years. It’s a bipartisan effort. The administration has signaled today that
they might not even accept that if Congress were be able to come to a bipartisan decision
to do this, that they might want to get more in order for the president to accept that. JUDY WOODRUFF: Well, it’s one more step in
a story that I feel has just gone back for eons. It’s only been a few years, but it’s gone
back for a long time, yet another wrinkle today. Julie Rovner, thank you very much.