Ongoing staffing shortages at the Internal Revenue Service could lead to higher premiums for some consumers who need tax credits to help pay their health-insurance premiums, Democrats say. The IRS is required to review applications from some consumers who need to sign up for coverage outside of the enrollment window and those who need an extension on filing taxes. Delays could also put their tax credits at risk, Democrats say.
The shutdown means the Indian Health Service hasn’t been able to continue paying tribal health clinics and programs, and some clinics may have to close or curtail operations.
And insurers say rule-making delays from the shutdown have left them scrambling to make key decisions about future participation in the ACA’s health-insurance exchanges. The insurers need that guidance to know how to design plans for 2020, but the rule release was delayed by months.
Some Democrats and consumer groups are pressing the Trump administration to limit any fallout on health care as the partial shutdown stretches into its 33nd day.
“We urge you to ensure that consumers are not faced with unexpected premium costs, do not lose coverage, and have access to the filing assistance they need,” according to a recent letter to Trump administration officials from six congressional Democrats, including Sen. Ron Wyden of Oregon and Rep. Frank Pallone of New Jersey.
President Trump and Democrats are at loggerheads over government spending for a barrier on the U.S. border with Mexico. Mr. Trump has called for $5.7 billion to pay for steel barriers and other border-security enhancements. Democrats have rejected the funding for a wall.
While the main agencies overseeing Medicaid, Medicare and the ACA remain open, employees at Health and Human Services and its agencies have been furloughed. The partial shutdown has also furloughed staff at other agencies such as the Treasury Department who are involved with implementing or setting policy related to the ACA.
As a result, some consumers who need their health-insurance applications reviewed by the IRS could experience delays in getting tax credits that reduce their premiums. Democrats are also worried the credits could be at risk for more people as the shutdown drags on.
Insurers have also been frustrated. HHS delayed releasing a proposal that outlines information carriers need when designing plans or deciding whether to participate next year in the ACA exchanges.
The proposed rule released last week still needs to undergo a public comment period before it is finalized. That leaves little time for insurers, which generally have to file information on their participation in the spring.
“This time frame will not allow insurers sufficient time to prepare products and operations for benefit year 2020,” according to a Jan. 15 letter to the Trump administration from the Association for Community Affiliated Plans and the Alliance for Community Health Plans. Both trade associations represent community-based, nonprofit insurers.
“It’s a challenge for us. It’s going to put a lot of pressure on us,” said Ken Janda, president and chief executive office of Community Health Choice, which offers plans on the exchange in the Houston area.
And the shutdown is taking a toll on health clinics that serve American Indians because grants to contractors are going unpaid. National tribal organizations in a Jan. 10 letter to Mr. Trump and top congressional leaders warned that the partial shutdown “breaks the treaty and trust obligations to tribal governments.”
Tribal governments are cutting health services and seven clinics will have to close if the shutdown continues, they said.
The situation has alarmed some lawmakers because other services, such food-distribution programs to reservations run by the Agriculture Department, are also in jeopardy because of the shutdown.
“#NativeAmerican #healthcare doesn’t belong in the middle of partisan bickering and political spending fights,” tweeted Rep. Markwayne Mullin (R., Okla.), who has introduced legislation to fund the Indian Health Service for a fiscal year.
Meanwhile, the shutdown has already prompted the Trump administration to request a stay in the appeal of a lawsuit seeking to invalidate the ACA. An appeal of a federal judge’s decision invalidating the law is on hold until the partial shutdown is over.
The delay increases the chances the lawsuit will remain unresolved for the 2020 presidential election. For now, the ACA remains in effect.