President Donald Trump's decision to end a provision of the Affordable Care Act that lowered out-of-pocket medical costs brought swift reaction Friday from the states, as health officials and consumers said they feared the action could chase millions of Americans away from coverage.
Attorneys general in at least a dozen states, including California, Connecticut, Kentucky, Massachusetts, Philadelphia and New York, said they planned to sue the Trump administration to keep the money flowing.
"This is a president who seems set on enacting reckless, unlawful campaign promises no matter the harm to families in America," Massachusetts Attorney General Maura Healey said during a conference call.
"President Trump swore an oath to uphold our laws. Under the Affordable Care Act, the Administration must make these payments, no matter the President’s personal views." Philadelphia Attorney General Josh Shapiro said in a statement.
At issue is a federal subsidy for deductibles and co-pays that helps lower costs for consumers with modest incomes. The Trump administration and many Republicans say the government cannot legally continue to make the so-called cost-sharing payments.
State officials say ending the subsidies will make insurance premiums skyrocket, forcing some consumers to give up having coverage at all.
"Scared, anxious and worried," said Carmen Parra, a 64-year-old Miami nanny when asked for her reaction to Trump's decision.
The federal cost-sharing payments cover nearly 95 percent of her deductible and co-pay costs. For example, she pays just $2 each for blood pressure and asthma medications, and an urgent care visit for one of her asthma attacks costs juts $15.
Without the subsidies, Parra said she could be forced to go without insurance.
"Please consider the people who need this assistance so they can live. Our lives depend on it," she said in Spanish through a translator.
Trump's announcement Thursday came weeks after the failure of the latest Republican attempt to repeal former President Barack Obama's Affordable Care Act — and just three weeks before the start of open enrollment, when many Americans who do not have health insurance through their employers can start picking their plans.
The payments to insurance companies are a major piece of Obama's overhaul, which extended coverage to low- and moderate-income people in multiple ways. More than 6 million people benefit from the cost-sharing subsidies, which cost the federal government about $7 billion. That cost is expected to more than double within a decade.