Trump Threat to Obamacare Would Send Premiums and Deficit Skyward By ROBERT PEAR and THOMAS KAPLANAUG. 15, 2017 Continue reading the main storyShare This Page Share Tweet Email More Save

President Trump at the White House on Monday. CreditTom Brenner/The New York Times

WASHINGTON — Premiums for the most popular health insurance plans would shoot up 20 percent next year, and federal budget deficits would increase by $194 billion in the coming decade if President Trump carries out his threat to end certain subsidies paid to insurance companies for the benefit of low-income people, the Congressional Budget Office saidTuesday.

The subsidies reimburse insurers for reducing deductibles, co-payments and other out-of-pocket costs that low-income people pay when they visit doctors, fill prescriptions or receive care in hospitals.

Even before efforts to repeal the Affordable Care Act collapsed in the Senate last month, Mr. Trump began threatening to cut off the subsidies, called cost-sharing reductions. He said the health care law would “implode” and Democrats would have no choice but to negotiate a replacement plan. Mr. Trump described his strategy as, “Let Obamacare implode, then deal.”

Those threats continue, though each month, the Trump administration has issued the subsidies.

The nonpartisan budget office has now quantified the cost of the threats.

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Read the C.B.O.’s Report

The nonpartisan Congressional Budget Office on Tuesday released its findings on the effects of eliminating payments for cost-sharing reductions under the Affordable Care Act.

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If Mr. Trump stops paying the subsidies, the budget office said, insurers will increase premiums for midlevel “silver” plans, and the government will incur additional costs because, under a separate program, it provides financial assistance to low-income people to help them pay those premiums.

The Trump administration has been providing funds for cost-sharing subsidies month-to-month, with no commitment to pay for the remainder of this year, much less for 2018.

Doctors, hospitals, insurers, consumer groups and the United States Chamber of Commerce have all urged Mr. Trump to continue paying the cost-sharing subsidies. Senator Lamar Alexander, Republican of Tennessee and the chairman of the Senate health committee, has said he plans to hold hearings next month, with a view to producing bipartisan legislation that would stabilize insurance markets and provide money for the subsidies.

“Without payment of these cost-sharing reductions, Americans will be hurt,” Mr. Alexander said recently.

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