Despite Trump’s Threat to Democrats, Budget Fight on ACA Subsidies Holds Hostages in GOP Districts, Too

Over the weekend, President Trump again threatened in a tweet to defund regularly scheduled cost-sharing subsidies in the Affordable Care Act, worth $7 billion dollars nationally, and $700 million in California. But despite his tweet stating that “the Dems need big money to keep it going,” our new analysis shows that about 200,000 Californians who benefit from these subsidies are in districts represented by House Republicans–the same House Republicans who filed the lawsuit that put these subsidies into question.

Earlier this month, Health Access California urged in letters to the state’s fourteen House Republican representatives to withdraw their challenge to $7 billion of health care subsidies that reduce cost-sharing for low-income Americans. The subsidies, for example, allow deductibles in an “Enhanced Silver” plan in Covered California to be reduced from $2,500 to $650 or even as low as $75, The pending House Republican lawsuit threatens to undo this funding source, of which California receives $700 million.

Over 600,000 Californians benefit from these subsidies–but the impact of losing these subsidies will impact the millions in the individual insurance market. To make up this loss, insurers have stated that they would spike premiums by around 20% or more, destabilizing the entire individual insurance market in 2018.

President Trump isn’t taking just Democratic hostages, he’s taking our whole health system hostage when he threatens to defund these regularly scheduled subsidies that allow patients to be able to afford getting the care they need. Even in blue California, 200,000 patients who get this financial assistance are in districts represented by House Republicans–suggesting they should have as much of an interest in keeping these subsidies funded in the budget negotiations this week.

We need the President and our Congressmembers to take the necessary steps to end this massive threat to the millions who depend on our individual insurance market. In particular, it is distressing that none of these 14 California House GOP members have called for the withdrawal of their lawsuit, which threatens to spike premiums both in and out of our Covered California marketplace.

It’s bizarre that we have our House GOP members suing to take away financial assistance from so many of their own constituents. The House GOP’s lawsuit puts at risk $700 million a year to help lower-income California families with cost-sharing reductions. Losing those funds would not only raise deductibles and co-payments for hundreds of thousands of Californians, but also spike premiums and potentially crash our entire individual insurance market.

In California’s fourteen Republican districts, the help that families get from just cost-sharing reductions range on average from $566-$700 annually, overall totaling $8.4 million-$21.3 million dollars in these districts annually. From the new fact sheet, below is some of the district data of the House GOP members that sponsored the lawsuit–data of other specific members of Congress are available upon request.

# Enrolled in Covered CA  # Getting Cost Sharing Subsidies     $ of Cost-Sharing Subsidies in District

LaMalfa (CD 1):     30,972                                  15,486                                             $15,882,257.00

McClintock (CD 4) 33,929                                  16,965                                             $16,439,023.00

Cook (CD 8)            20,576                                 10,288                                             $10,094,136.00

Denham (CD 10)     29,665                                 14,833                                             $14,967,661.00

Valadao (CD 21)      15,799                                 7,900                                              $8,424,399.00

Nunes (CD 22)         22,942                                 11,471                                           $12,113,198.00

McCarthy (CD 23)   18,597                                 9,299                                             $9,649,933.00

Knight (CD 25)        23,207                                 11,604                                           $10,269,916.00

Royce (CD 39)         40,994                                 20,497                                           $21,269,312.00

Calvert (CD 42)      27,724                                  13,862                                            $12,367,679.00

Walters (CD 45)     35,477                                   17,739                                            $16,139,918.00

Rohrabacher (CD 48) 37,116                              18,558                                            $17,834,156.00

Issa (CD 49)             32,425                                16,213                                            $14,374,446.00

Hunter (CD 50)         28,978                               14,489                                            $13,297,356.00

TOTAL                     398,401                             199,201                                         $193,123,390.00

Of note:

  • The constituents with the highest annual cost-sharing reduction are in Rep. Valadao’s Central Valley district, who receive, on average, $700/year in assistance.
  • Rep. Royce’s Orange County district would have the most people impacted, given its very high Covered California enrollment (45,639 people).
  • Fairly typical is Rep. Denham, who has over 32,000 Covered California enrollees in his district. About half, or over 15,000, receiving cost-sharing reductions, averaging $646/year. Overall, the cost sharing reductions are worth almost $15 million to Rep. Denham’s constituents and the health system they rely on.

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