Don't be fooled. After finally agreeing to pay the August Affordable Care Act (aka Obamacare) cost sharing reduction (CSR) payments to insurers, Trump and corrupt Secretary of Health & Human Services, Tom Price, remain committed to destroying Obamacare. Their goals are to pay less in subsidies that help people purchase individual health insurance plans and pay for medical care, and to scare health insurers away from the exchanges by injecting uncertainty about future subsidy payments.

Unfortunately, and despite the latest CSR payment, Trump and Price's sinister plot to undermine Obamacare is having the intended effect. Because health insurers cannot be certain that this Administration will not stall or stop future subsidy payments, they will increase rates by a higher percentage than they otherwise would have. And when health insurers feel uncertain and are afraid they won't meet their financial objectives, they take it out on everyone. That means health insurance premiums may be higher for everyone next year, even employer-sponsored group health plans.

But that is not all on Trump and Price. Their childish, mean-spirited antics only highlight a fundamental problem with a for-profit, private sector led health insurance industry. You see, American health insurers have always insisted that their profits be assured. Taking a loss in one line of business (selling to individuals) and making it up in another line (employer-sponsored and other group insurance), but still making an overall profit, is viewed as a loss for them. They want all of their lines of business to be profitable all of the time.

Even if Trump and Price admit that the Republican health care reform efforts have failed, that they will now honestly administer the Obamacare law as intended, and promise to make all future CSR payments on time, insurers will still raise rates higher than are needed until they feel comfortable that their profits will continue. How long will they wait until they are comfortable that their profits are not in imminent danger? They will wait as long as they want to, which is forever, and there is nothing we can do about it.

Health Insurers Will Always Inflate Premiums

It is so disingenuous for Obamacare critics to imply that the health insurance market was ok or even better before Obamacare. How they ignore or explain away that purchasing individual health insurance pre-Obamacare was hit or miss or that finding comprehensive and affordable coverage was impossible is beyond my comprehension. Purchasing individual health insurance pre-Obamacare was a long and difficult experience. First, you had to find a reputable insurer that sold individual plans, and then you had to work with an insurance broker to apply and purchase the policy because you couldn't work directly with the insurer. And that describes the not too bad parts of that old way of purchasing insurance. The fact that tens of millions could not purchase individual health insurance, some because they didn't want to, but many because they were denied or couldn't afford it, tells you everything you need to know about why Obamacare or something like it was bound to happen.

But not even Obamacare could avoid appeasing private health insurers by promising to provide them a better risk pool or subsidies; all in the hope that someday they will share their savings with the rest of us by lowering their rates. Health insurers will always inflate their rates because there is no pressure to do otherwise, but there should be.

Is This Even Insurance?

Except for Senator Bernie Sanders' statements, every health care reform "proposal" tries to make offering health insurance more attractive to private health insurers. Not even the latest idea from Democratic Senator Brian Schatz offers health insurance costs relief, and you would think buying into Medicaid would at least do that.

Are private health insurance company networks of doctors and hospitals and mostly unknown negotiated medical care discounts irreplaceable by another system? Why do we assume we are getting our money’s worth from companies who admit that they are unwilling to take a risk on a business that is all about risks? And shouldn't they have to work harder for their money by assessing risks better and negotiating higher discounts that lead to lower premiums, and pass on these savings?

Worrying about health insurance company profits and asking for nothing in return for our efforts is a sure way to keep health insurance unaffordable for the foreseeable future.

Tags: CSR, obamacare, Medicaid, health insurance