Friday, 20 October, 2017

Insurers say Trump must do more to stabilize 'Obamacare'

Trump administration issues final rule on stricter Obamacare enrollment Insurers say Trump must do more to stabilize 'Obamacare'
Craig Ferguson | 15 April, 2017, 02:41

One big problem in boosting enrollment is that many potential consumers — particularly younger, healthier ones — say premiums are too high. Insurers, doctors, hospitals and the business community have asked President Donald Trump to preserve ACA "cost-sharing" subsidies that pare down high deductibles and copayments for consumers with modest incomes. Without the payments, experts say, the government marketplaces that provide private insurance for about 12 million people will be overwhelmed by premium increases and insurer departures. But the law was also created to provide $7 billion per year in "cost sharing reduction" payments to insurance companies so that people below 250 percent of the poverty line would have lower deductibles and copayments.

They would cut the marketplace enrollment period in half, from three months to 45 days - November 1, 2017, through December 15, 2017 - for coverage beginning January 1, 2018.

"We intend to conduct outreach to consumers to ensure that they are aware of the newly shortened open enrollment period", according to the document.

The Trump administrations proposed rule aimed at stabilizing the health laws insurance marketplace could have rapid, dramatic effects on people who do not get insurance through work and buy it on the Affordable Care Acts exchanges. "Losing health plans from the exchanges is still a risk for 2018".

The Affordable Care Act enabled 20 million Americans to gain insurance, mostly through the individual insurance markets set up by the law or through an expansion of Medicaid, the government health insurance programme for the poor and disabled.

The rules, published on Thursday by the Department of Health and Human Services, include shortening the health law's sign-up season and limiting exceptions that let people enroll for plans outside the regularly allotted period.

An estimated 21 percent of individual market plan members stopped premium payments in 2015, and almost 90 percent purchased new plans in 2016 - about half purchased the same plans they had stopped payments on, the proposal says. In an interview with the Wall Street Journal Wednesday, Trump suggested that unless Democrats agree to his plans to dismantle Obamacare, he might use his executive authority to intentionally trigger a death spiral for the individual insurance markets.

"I don't want people to get hurt", Trump told the Journal.

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Americans probably won't know for certain what sort of choices they will have until late summer or early fall, a couple of months before open enrollment begins. Some insurers say they've lost hundreds of millions of dollars, and many have pulled back or are considering doing so.

This year saw premium increases averaging 25% for a standard plan in states served by HealthCare.gov.

All eyes are now on Anthem, a big Blue Cross-Blue Shield insurer operating in several states that has yet to announce its intentions for 2018. CEO Joseph Swedish has said his company would not commit to participating next year.

Rep. Frank Pallone, the ranking Democrat on the House Energy and Commerce Committee, said that the new rule "will not produce any meaningful improvements for the stability of the ACA Marketplace" and said aspects of the rule would prove negative.

Dave Dillion of the Society of Actuaries said growth in underlying medical expenses could drive coverage prices up another 10 percent or more.

Nonetheless, the nonpartisan Congressional Budget Office says the ACA markets will be stable next year in most areas.

In Washington, Republicans are trying to resolve an impasse between hard-liners and moderates that has prevented them from getting their own health care bill through the House. But the cost-sharing reduction issue is only the leading edge of a number of uncertainties that could affect how well the markets function. The case is on hold.

After meeting with former Republican congressmen and senior advisers to Trump, Height Securities analyst Andrew Parmentier is convinced that Republicans will be taking another stab at healthcare reform in the near future.

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