News Brief: Trump Ends Health Care Subsidies, Iran Deal, California Fires

The Trump administration says it will end cost-sharing payments designed to help low-income Americans get health care. Trump is also expected to make an announcement on the future of the Iran deal.

STEVE INSKEEP, HOST:

Yesterday, when President Trump signed an executive order on health care, he made a promise.

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PRESIDENT DONALD TRUMP: Today is only the beginning.

DAVID GREENE, HOST:

In the months ahead - he may as well have said in the hours ahead because soon after, the administration delivered another blow to Obamacare. The administration says it's going to stop paying payments - making payments to insurance companies. These payments were designed to subsidize health care for Americans with low incomes. Ending these subsidies could cause premiums to spike or insurance companies to leave the markets altogether. So what exactly is the president's strategy here?

INSKEEP: Let's put that question to NPR's Scott Horsley, who covers the White House. Scott, good morning.

SCOTT HORSLEY, BYLINE: Good morning, Steve.

INSKEEP: I've got to note the president has said again and again, let Obamacare collapse. Is this an attempt to help it collapse?

HORSLEY: It certainly looks that way, Steve. The White House counts this action - in legalistic terms, it said it was guided by opinion from the Department of Justice because these subsidies had not been annually authorized by Congress. But the timing suggests this is a deliberate attempt to make the president's implosion claim a self-fulfilling prophecy. And it's one of several steps the White House has taken to do that. The president has also shortened the sign-up period for people to join the Obamacare exchanges. He's gutted the budget for marketing efforts. And as you mentioned, just yesterday, he signed that executive order, which relaxes the rules on alternative forms of insurance.

INSKEEP: Do these steps mean that people are going to be paying more for health insurance or even not have an opportunity to get health insurance?

HORSLEY: You know, a lot of insurance companies had already priced this in to their premiums for 2018 because the president's been threatening to take this step for months. In fact, some state regulators asked insurance companies when they drew up their prices for 2018 to price their policies two ways - with the subsidies and without. And there's a big difference. In some cases, it's the difference between a single-digit percentage increase in premiums for next year and a 20 percent-plus increase. So this will contribute to higher premiums. It will make insurance companies less eager to participate in the Obamacare exchanges. In many cases, that damage was already done. And this sort of locks it in.

INSKEEP: Yeah. We were just talking yesterday with the Iowa insurance commissioner, where they're talking about premium increases of 57 percent - in some cases more. And so this may be may be part of that. But I have to ask, Scott Horsley - after the failure of efforts to repeal and replace Obamacare, there was a bipartisan effort in the Senate, at least, to fix the insurance markets. Whatever happened to that?

HORSLEY: That effort has pretty much stalled, although, you know, just last weekend, the president tweeted that he'd had a conversation with Chuck Schumer, the top Democrat in the Senate, about possibly doing a deal with Democrats to fix Obamacare. Schumer, however, said that the president was just still trying to repeal the measure. And that was a nonstarter as far as he was concerned. The - Senator Schumer and Nancy Pelosi, the top Democrat in the House, issued a joint statement last night. They called this a spiteful act of vast and pointless sabotage. And they said, make no mistake. While Trump will try to blame Obamacare itself, the blame will fall on the president.

INSKEEP: OK. Scott, thanks very much. Really appreciate it, as always.

HORSLEY: You're welcome, Steve.

INSKEEP: That's NPR's Scott Horsley.

So if the Affordable Care Act is President Trump's biggest punching bag, the nuclear deal with Iran is right up there.

GREENE: I think that's safe to say, yeah. President Obama negotiated this deal with Iran and other world powers. It was signed in 2015. It's meant to keep Iran away from developing a nuclear weapon in exchange for lifting economic sanctions. President Trump has never liked it, though his national security team has said it is in the U.S. interest to keep it. Here's the chairman of the Joint Chiefs of Staff, Gen. Joseph Dunford, testifying to Congress last week.

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JOSEPH DUNFORD: Iran is not in material breach of the agreement. And I do believe the agreement to date has delayed the development of a nuclear capability by Iran.

INSKEEP: So what's the president going to do to reshape the U.S. approach? NPR's Peter Kenyon covered the negotiation of this deal, has continued to cover Iran. He's on the line now from Istanbul. Hi, Peter.

PETER KENYON, BYLINE: Hey, Steve.

INSKEEP: We should mention White House officials have given a few answers about their intentions here but not all of them. What's the president likely to do, as best you can tell?

KENYON: Well, he's got a few options. This law allows him to decertify the nuclear deal. He could say Iran's not complying, but that's kind of tricky because virtually everybody else says Iran is complying. He could find the deal isn't in America's national security interests. Or - and this may seem more likely - he could decertify because of some of the terms of the deal - if he thinks Iran got too much out of it, for instance. Now, that would essentially be a U.S. president disowning an accord that America's party to. But that's not the same as pulling out of the deal. That decision would be left to Congress.

INSKEEP: So then legislation would be considered. And the White House and lawmakers have been talking about legislation that would, well, do what? What's the approach they could take?

KENYON: Well, whatever they can get enough votes for, basically. They could...

INSKEEP: (Laughter).

KENYON: You know, they could simply reimpose sanctions. That's the toughest line. And comments to date suggest they're not too thrilled with that idea. They don't like that option because that would take the U.S. out of the deal. Let's be clear about that. They could also just get rid of this current 90-day certification ritual and come up with some other ideas - different deadlines, criteria. If Iran does X, then we reimpose the sanctions at a later date. That might be seen as strengthening the deterrent. But it would also be unilateral unless, somehow, the Trump administration can get Europe, Russia and China onboard.

INSKEEP: It's interesting there's also talk of legislation that would extend some of the terms of this deal, at least on the U.S. side. One of the big complaints is that some provisions only last 10 or 15 years. And this would say that they essentially last forever, as far as the United States is concerned.

KENYON: Exactly - as far as the United States is concerned. And that may or may not be a deal breaker - probably not, actually.

INSKEEP: How's Iran taking all of this?

KENYON: Well, they've issued various threats - and none of them very specific. They seem most concerned about these moves against the Revolutionary Guard Corps, which could be a target of some actions by the government here - the government there in Washington. President Hassan Rouhani gave a very unusual speech recently praising the IRGC, which he has feuded with in the past. He's now embracing it as part of the national fabric. That's a sign that he's worried about attacks from his right flank from hardliners in Iran. I think, basically, there's also problems in Europe, where they've warned that pulling out of the deal would be a catastrophe and a grave misstep. So if instead the Trump administration decertifies but stays in the deal, they might be kind of relieved.

GREENE: Seems like - is there an approach that we're seeing here from the president, Steve? I just - you think about Iran. You think about health care. You think about immigration. It's like disrupt, upend and then throw to Congress. And you say, do something with this. It's extraordinary.

INSKEEP: And another example of a policy where the president is very unhappy with what the previous president did.

GREENE: Exactly.

INSKEEP: But it's not clear what can be done instead. That's NPR's Peter Kenyon in Istanbul. Peter, thanks very much.

KENYON: Thanks, Steve.

INSKEEP: And now let's hear about how people are dealing with wildfires.

GREENE: Yeah. There are really two kinds of people affected by the wildfires in California. Some are in the path of the fire, and they have been literally fleeing for their lives. There have been lives lost. Others may be farther away, but they're finding the fires affecting their lives because smoke is now covering the Bay Area. The air quality is on par with what you might think about in major cities in China. And this is forcing people to wear face masks when they go outside. Several schools are even closed today.

INSKEEP: Reporter John Sepulvado is going to give us a breath of this. He's at member station KQED in San Francisco. And, John, how you breathing?

JOHN SEPULVADO, BYLINE: Well, I'm breathing OK today. It does not feel like I'm in the bad end of a barbecue. But there have been times where it has actually hurt to breathe. And I'm an absolutely healthy man in my 30s, so there's no reason why it should. If you are elderly, if you are a child, if you have an already existing breathing condition, this has been horrendous. And make no mistake - it is the worst air quality on record here in the North Bay because of these wildfires.

INSKEEP: And is this true through much of this metropolitan area of several million people?

SEPULVADO: Yeah. I mean, this is something that is affecting between 2 to 9 million people, depending on where the winds shift.

INSKEEP: Now, when you actually are covering the fire itself, what has struck you this week as this has gone on day by day?

SEPULVADO: This has struck every single strata of this community. So I have seen homeless people fleeing from their encampments. I have seen retirees, who are retirees with very little, watch their houses burn. I have seen middle-class families, the quote, unquote, "soccer moms," be affected by this. I've seen the president of the local chamber of commerce house burn. I've seen the very, very wealthy - some of these holes are very exclusive. People with four-car garages. The garage doors exist still. But the garages are burned to the ground. It has been incredibly just awesome to remind oneself that in the destructive power of nature, we are all equal.

INSKEEP: We were told the other day that firefighters were still just trying to rescue people - that controlling the fire wasn't even something they could imagine yet. How about now?

SEPULVADO: Yeah, I don't think that we're still at that point. This is really a fight of inches and nights (ph). So I will say this. I am really heartened that as of right now the town of Calistoga, about 6,000 people, has not caught on fire. It doesn't sound like much, but there is no fire. There are no structural fires in that town. And that is a huge win for firefighters - second night in a row. So you can tell they're doing everything they can. It's going to be a long fight.

INSKEEP: NPR's John Sepulvado - reporter John Sepulvado. Thanks very much.

SEPULVADO: Thank you.

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