CSR and exit clauses

This is the statement from the acting Secretary of Health and Human Services.  The last word is critical:  “Immediately”


Immediate termination is critical because the contracts insurers signed for 2017 and 2018 each had exit clauses.   The 2018 contract language looks like this:

Tomorrow morning I expect the state attorney generals that were brought into the CSR case to file for an injunction. If that fails, I expect a dozen lawsuits to be filed as well.  If those don’t produce an injunction, we will need to watch and see which insurers run from the individual market over the weekend.  Some may be able to do so as state law could allow for them to flee from a material event.  Other states will lock insurers in for months of notice.



78 replies
  1. 1

  2. 2

    Things have been going badly for Trump, so he has decided to hurt people. See also his tweets on Puerto Rico.

  3. 3
    khead says:

    Fuck these people. All of them.

  4. 4
    🌎 🇺🇸 Goku (aka The Hope of the Universe) 🗳 🌷 says:

    As I’ve said before, that debilitating stroke can’t come fast enough for that motherfucker Trump.

  5. 5
    Hellbastard says:

    There’s not a pit in hell that is deep and dark enough for Donald Trump.

  6. 6
    Emerald says:

    Can somebody stop this through the courts?

  7. 7
    Scott S. says:

    …I have no idea what any of this means.

    Is my insurance going to be good tomorrow? Will I have to pay an increased rate next month? Is the enrollment period still starting on Nov. 1?

  8. 8
  9. 9
    joel hanes says:


  10. 10
    pattonbt says:

    Is today the single most petty and spiteful behavioural day by a President in modern history?

  11. 11

    @Scott S.: Insurance will good tomorrow. Not sure about anything else. Will know more by tomorrow night.

  12. 12
    🌎 🇺🇸 Goku (aka The Hope of the Universe) 🗳 🌷 says:

    I’m talking about “reduced to drooling vegetable” level stroke. And I hope it happens during his next stupid fucking signing ceremony so it would be caught on tape. I’ll make sure it’s DVR’ed.

  13. 13
    tinkletoes says:

    Merry Christmas

  14. 14

    @pattonbt: a bit light on genocide for that.

  15. 15
    Rheinhard says:

    A good friend of mine who has been unemployed for several years and on Obamacare exchange individual plans had a surgery a while back which is due for a followup surgery to close up the remaining parts. Although he has some other medical conditions that have made getting this followup surgery difficult, he has demanded of his doctors that he get it done this year.

    When asked by his doctors why this is so urgent, he says “Because Republicans are going to blow up the subsidies that allow my insurance plan to exist, and I expect by next year my followup surgery would not be covered or paid for.”

    Looks like he was right!

  16. 16
    Chris says:

    @Scott S.:

    Frankly, that’s been me all fucking year (and lots of other people). They’ve been dangling a sword of Damocles basically since inauguration day, and I never have any idea whether when I go to bed in the morning, it’ll have dropped by the time I wake up.

  17. 17
    MomSense says:

    I have to have some minor surgery but I’ve been putting it off. Guess I need to hurry up. Ugh.

  18. 18
    Jim, Foolish Literalist says:

    Eric Schneiderman‏Verified account @ AGSchneiderman 1h1 hour ago
    #BREAKING Mr. President, stop using NY families as political pawns. We’ll sue to defend #ACA subsidies.

  19. 19
    pattonbt says:

    @Major Major Major Major: fair enough. but they days not over yet….(at least on the west coast)

  20. 20
    Percysowner says:

    @🌎 🇺🇸 Goku (aka The Hope of the Universe) 🗳 🌷: You are much nicer than I am. I want Locked in Syndrome, where his mind continues to work, but he is completely incapable of communicating anything.

    Then I realize that Pence will do the exact same thing, as will everyone in the line of succession and I get depressed.

    I don’t believe in Hell, I do hope for reincarnation where all of these guys come back as the people they have worked so very hard to hurt.

  21. 21
    dmsilev says:

    Via TPM, joint statement from Pelosi and Schumer:

    “Sadly, instead of working to lower health costs for Americans, it seems President Trump will singlehandedly hike Americans’ health premiums. It is a spiteful act of vast, pointless sabotage leveled at working families and the middle class in every corner of America. Make no mistake about it, Trump will try to blame the Affordable Care Act, but this will fall on his back and he will pay the price for it.

    “President Trump has apparently decided to punish the American people for his inability to improve our health care system. Trumpcare collapsed because Americans overwhelmingly recognized the cruelty and higher costs it meant for them and their loved ones. Now, millions of hard-working American families will suffer just because President Trump wants them to.

    “If these reports are true, the President is walking away from the good faith, bipartisan Alexander-Murray negotiations and risking the health care of millions of Americans.”

    Neoliberal sellouts, clearly.

  22. 22
    efgoldman says:


    They’ve been dangling a sword of Damocles basically since inauguration day

    I’m overf 70, qnd fully covered by medicare and a medicare advantage program
    mrs efg,however, just turned 63 in July, She’s in a heavily subsidized but still fairly expensive exchange, We’re hoping we can hold it together for that many more months, That assumes they don’t start fucking with medicare,

  23. 23
    Duane says:

    Trump doesn’t care how many people he kills. He is psychotic, unfit for office, and must be removed.

  24. 24
    Jim, Foolish Literalist says:

    I believe a retiring Republican MoC, but any talking point in a storm of spite and bullshit

    Sahil Kapur‏Verified account @ sahilkapur 2h2 hours ago
    Here’s a Republican member of Congress accusing the president of health care sabotage.,
    Ileana Ros-LehtinenVerified account @ RosLehtinen
    Cutting health care subsidies will mean more uninsured in my district. potus promised more access, affordable coverage. This does opposite.

  25. 25
    Ruckus says:

    How about any history?

  26. 26
    🌎 🇺🇸 Goku (aka The Hope of the Universe) 🗳 🌷 says:

    We all know that. Even the Republicans. Some have even started publically questioning his sanity like Corker. I suspect that Corker is only saying so because he is not seeking reelection. They have to understand: their careers won’t matter if the US is a pariah state if Donald decides to preemptively nuke North Korea and kills millions; the US would collapse in a matter of a few years or decades judging by how divided and brittle public order is right now not to mention international pressure in such a scenario.

  27. 27
    Lizzy L says:

    I don’t drink alcohol (except a very occasional beer) any more, but this makes me want to go out and buy something stronger than beer. I am so angry. This is going to hurt so many people. Damn him, and all of them for allowing it to happen.

  28. 28
    vhh says:

    @David Anderson: what does “will good tomorrow” mean?

  29. 29
    🌎 🇺🇸 Goku (aka The Hope of the Universe) 🗳 🌷 says:

    Insurance will be ok tommorow probably. After that, perhaps not.

  30. 30
    Ruckus says:

    This is the first real shot in the war he wants to wage.
    It’s not other countries that he wants to blow up, it’s this one.
    If he and his coalition of bigoted fucks have their way we won’t have to worry about nuclear war, a lot of us won’t be alive to see it.

  31. 31
    Timurid says:

    It’s not other countries that he wants to blow up, it’s this one.


  32. 32
    ProfDamatu says:

    Oh, holy hell. There are no words. These people truly do not care how many people are hurt or killed; they want their damn “win.”

    I wonder what the possibility space is here, or what’s more likely. Insurers flee period, for this year and next? Insurers try to escape for this year, but “return” next year, as 2018 premiums mostly were set assuming CSRs would not be paid? So much mental energy spent on this bullshit, that could have been put to much better use. :-(

  33. 33
    joel hanes says:

    I showed my very nice 85-year-old Mom the news.

    She said “He’s a bastard, isn’t he.”

    She never ever uses language like that.
    But she’s right.

  34. 34
    Lizzy L says:

    @Ruckus: No, he wants a war TOO. He’ll enjoy the cries of distress from this coming from Democrats and maybe some members of the press, and then he’ll get bored and start thinking about bombs again.

  35. 35
    Wag says:


    where his mind continues to work,

    Assumes fact not in evidence.

  36. 36
    joel hanes says:


    I want Locked in Syndrome

    You’re too nice. You know Wesley’s description of “to the pain” in The Princess Bride ?

  37. 37
    John Revolta says:

    @Chris: It’s starting to drive me nuts. I thought we were at least good until the end of the year. Now I don’t know if we can afford to keep our appointments next week.

  38. 38
    Mary G says:

    I am boycotting Twitter, but Saturday I am going to rage out on these evil idiots. They are inflicting cruel and unusual punishment on the American citizens least able to hear it.

    I hope that this is what it takes to get his approval rating down to his proper 27%, or lower.

  39. 39
    Duane says:

    @🌎 🇺🇸 Goku (aka The Hope of the Universe) 🗳 🌷: Every statement, every proposal, every policy puts people in harms way. I just can’t believe that the President is nuts.

  40. 40
    Shalimar says:

    Politically, this seems really stupid. It creates an ongoing healthcare crisis that will extend through the whole year, including the 2018 election. Which means millions of people will be getting sick the week of the election and telling their friends and family that they can’t afford to go to the doctor anymore because Fuck Trump and Fuck Republicans.

  41. 41
    Baud says:

    This is great, just as CHIP is about to crash.

  42. 42
    Mike J says:

    Here’s my courtroom experience today:

    Prosecutor: We accept this panel
    Defense: We would like to thank juror 7 for her service and dismiss her.
    Bailiff: Number 56 please move to seat 7 in the jury box.
    Prosecutor: We would like to thank juror 7 for his service and dismiss him.
    Bailiff: Number 58 please move to seat 7 in the jury box.
    Defense: We accept this panel
    Prosecutor: We accept this panel.
    Mike J, number 59 and next in line for a minimum two week trial: Phew.

    And fuck Trump.

  43. 43
    Proudgradofcatladyacademy says:

    I can’t sleep. I have been crying all night, refreshing my smart phone for news. Not only are people’s health and lives at stake if insurers pull out but my livelihood, my job depends on the exchanges.

    Not sure what to do now.

  44. 44
  45. 45
    Mary G says:

    A.G. Schneiderman of New York will be waiting on the courthouse steps before it opens to file the first lawsuit.

  46. 46
    Villago Delenda Est says:

    Donald knows NOTHING of the Constitution.

    He’s like Sgt Schultz in that way.

  47. 47
    Proudgradofcatladyacademy says:

    @Another Scott:

    Thanks. I just turned down lower paying job this week from another division. Even with UHC being in one state in 2018 I never imagined this happening with the repeal efforts failing. Plus we have more than enough work fixing 2016 and 2015 issues
    Calling Franken, Nolan, and Klobauchar’s offices in morning to ask about leglistation.

    What an awful thing to do with people’s lives and health.

  48. 48
    Baud says:

    Since this increases the deficit, Trump further undermined tax reform.

  49. 49
    Mike J says:

    I can no longer talk with anyone at all without becoming furious, and everything I read by my contemporaries makes me quiver with indignation. A fine state to be in! Not that it’s preventing me from preparing a book in which I’ll try to spew out my bile. I’d like to talk with you about it. So, as you see, I’m not letting myself be disheartened. If I didn’t work, my only course would be to jump in the river with a stone around my neck. 18702017 drove many insane, made imbeciles of others, and left others in a permanent state of rage. I’m in the last category. It’s the right one.

    Meanwhile, take care of your gout, my poor friend, and know full well that I love you.

  50. 50
    Villago Delenda Est says:

    @Baud: Deficits don’t matter when a Rethug is in the White House.

  51. 51
    Baud says:

    @Villago Delenda Est: No, but they do matter for reconciliation purposes.

  52. 52
    Villago Delenda Est says:

    @Shalimar: The important thing is to destroy the ni*CLANG*’s legacy.

    Nothing else matters to Donald. Nothing.

  53. 53
    Ruckus says:

    @Villago Delenda Est:
    Sgt Schultz knew what he didn’t know.
    drumpf knows shit. And thinks it smells good.

  54. 54
    Ruckus says:

    @Villago Delenda Est:
    drumpf is the racist’s racist.

  55. 55
    Ruckus says:

    @Mike J:
    Tomorrow is my 50th HS reunion. I’m going but with trepidation. I know some of my classmates are drumpf supporters and I was not sure I can be civil. As of this afternoon I’m far less sure.
    But really, was this unexpected? It’s President Obama’s shinning accomplishment. No matter if you think we should have a lot better system of healthcare, this was a huge step forward. And as @Villago Delenda Est: said, to the asshole in chief nothing else matters.

  56. 56
    Uncle Ebeneezer says:

    @Villago Delenda Est: The irony though is everything he does only make Obama look even greater than he already did.

  57. 57
    Aleta says:

    Indictments are coming. Let’s hang tough a while longer.

  58. 58
    WaterGirl says:

    @Mike J: It looks like at least one good thing happened today!

  59. 59
    WaterGirl says:


    what does “will good tomorrow” mean?

    I’m pretty sure he meant to say “will BE good tomorrow”.

  60. 60
  61. 61
    Amir Khalid says:

    We speculate a great deal here over whether der Trump still has all his marbles. I tend to think he still has more than half of them left. But when he acts with intent, he always does something evil. I have to conclude that Trump was evil to begin with, and Trump with all his marbles would be a greater force of evil than he is now.

  62. 62
    Ruckus says:

    @Major Major Major Major:
    I didn’t really mean be uncivil. I meant be really fucking uncivil. But I like some of these people and I’d really not like to fuck up their party. I may have to resurrect my professional persona, where I smile and nod, all the while thinking “What a fucking moron!” But I haven’t had to do that for 12 yrs now, and I’m out of practice.
    OTOH, just be uncivil. Mmmmm, that might just work.

  63. 63
    Ruckus says:

    @Amir Khalid:
    He may have a few marbles in there, but they are all broken into tiny sharp pieces and it’s irritating the fuck out of all of us.
    Your conclusion about him being always evil is right on though. But his not being able to do anything but be angry is why I think Alzheimer’s is quite possible. A friend told me about his mom, a real sweetheart, he’d never heard her swear in his 50+ yrs but when she was suffering from Alzheimer’s she would go on rants with every other word ones that he seldom used. It isn’t uncommon and actually understandable if you’ve known anyone with it. My dad would wake up in the middle of the night like that.

  64. 64
    Aleta says:

    Whatever amount of power t. had at any time over the years, he’s used to hurt people. Cowardly sadist. I wish the women who came forward against him had been better supported, so that more women had felt it safe to speak. There must be many more, as well as the people who know about his other crimes. If only his real power base would become afraid of continuing to shield him. That base includes banks, lawyers, the media–NBC, CNN–and they only listen to money.

  65. 65
    Fair Economist says:

    I don’t see how there’s any question that Trump has some significant mental deterioration in addition to his personality issues. He had to be reminded to sign that executive order today, and that’s not even the first time he’s forgotten what he’s doing in public at a major event.

  66. 66
    daveNYC says:

    @pattonbt: Maybe. I think he’ll manage to top even this though. Maybe he’ll follow through on pulling FEMA out of Puerto Rico.

  67. 67
    Aleta says:

    @Fair Economist: I saw with my mother how stress made her memory and functioning and confusion worse. If I could help her relax, she got clearer about what was happening. I’ve wondered if they take him golfing every week to keep him from going entirely to pieces.

    Also wonder how much they may be medicating him to control the anger, and at night to make him sleep. Supposedly sleeping pills and tranquilizers can cause memory loss. Meds for nerve pain too; he walks like he might have stenosis or something. Perhaps they even have to medicate him before letting him in front of cameras. To be sure he won’t start sceaming at the people fake-applauding him.

  68. 68
    mai naem mobile says:

    I am hoping Asshole Pigfucker in Chief Dolt45 knows Mueller is going to smash a hammer on his ass today and he’s acting out because that’s what he does. If it’s not that then he’s even a bigger asshole than I thought.

  69. 69
    Manyakitty says:

    @Aleta: whatever the cause, he can’t possibly be suffering as much as he deserves. Every single cynical fucker who voted for that piece of shit has blood on their hands.

  70. 70
    joel hanes says:


    not sure I can be civil

    There is a kind of opaque, icy politeness perfected by the English that gives no purchase for argument.

    When I can’t pull that one off, I find it works to firmly close my mouth, be silent for one beat, and then act as if I must go to the restroom right away, or refresh my drink, turn my back and walk away. “Excuse me for a moment” is all one need say.

    There’s almost no greater societal sanction than shunning. I was on a SE Alaska cruise in Aug, and the Trumpists among the passengers discovered that most of us had very little to say when they sat at our dinner table, and less interest in what they had to say, after a couple awkward and mostly silent meals, they all clumped together at three tables where they could talk about “those people”. No one said anything, but I think they knew.

  71. 71
    Steve in the ATL says:


    whatever the cause, he can’t possibly be suffering as much as he deserves.


  72. 72
    SFAW says:


    I believe the appropriate, professional response would be something like this:

    “I’m sorry, but I look at the person Russia helped get selected for the Oval Office, and look at what he does on a daily basis, and have concluded that he is doing his utmost to destroy the ‘America’ that most of us — including you stupid motherfuckers — recall as being a wonderful place. He has not intentionally told the truth since he started his campaign, he shown himself, frankly, to be among the stupidest and most anti-American occupants of the Oval Office. EVER. I remember you as being a reasonably intelligent, decent person, so I’m not sure if the years have made you stupid, or just evil, or if you’ve suffered some debilitating brain damage, or what. But what I DO know is that you continue to support a Russian puppet who is doing his best to turn America into a Third World country. Have a nice day, motherfucker!”

    An alternative response, in case you deem the above inappropriate, might be: “FOAD, motherfucker. You and your fellow morons support an evil motherfucker who is trying to hurt me and the people I love. Consider killing yourself, before Deadbeat Donnie does something that ends up killing you first.”

    If that’s STILL not the right tone, then I can’t help you, sorry. Although you might consider carrying a Louisville Slugger with you. Just in case, because actions speak louder than words.

  73. 73
    Aleta says:

    @SFAW: I like the first one.. Should be a TV ad.

    For small talk there’s always “WTF are you talking about?” on a loop.

  74. 74
    manyakitty says:

    @SFAW: Yeah well. I just called my trumpy boss a traitor and kicked him out of my office for popping in to crow about whatever bad Clinton news happened. Then I apologized to the people I supervise. I should probably go say something to him, too, but I can’t right now.

  75. 75
    satby says:

    @manyakitty: I basically call all Drumpf supporters traitor enablers. They really don’t like that. It’s shut a few of the more dedicated to moronic “conservative principles” down on FB, and they don’t try to argue with me now. I have no illusions about them seeing any light, but shutting them up works for me.

  76. 76
    manyakitty says:

    @satby: Thanks. I usually do better at keeping my cool at work, but it was just too much today. Sigh.

  77. 77

    […] to do so may mean that that insurer cannot offer their plans in the healthcare exchanges. But, as David Anderson pointed out, there’s also language to allow insurers to leave the exchanges if these CSRs are […]

  78. 78
    ken says:

    The 2018 QHIPs for AR, KY, NM, NV and OR do NOT contain this exit language. See https://www.qhpcertification.cms.gov/s/QHP%20Agreement and
    https://www.qhpcertification.cms.gov/s/QHP%20Agreement Art V

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