Insurers say Trump must do more to stabilize 'Obamacare'

Apr 18, 2017, 01:50

In many ways, Obamacare got a lot of things right. The change follows the schedule that would have been in effect for 2019 under the ACA. It also would allow Rosendale to vet high-deductible health plans other states are using. In other words, it set the precedent for what basic health coverage should be.

The administration and Congress could keep insurers guessing over whether it will continue federal payments that lower deductibles and copays for millions of Americans next year. It also lets insurers pay a lower percentage of medical costs and allows them to refuse coverage to people who haven't paid their premiums. Obamacare ended that practice and required that insurers accept all members and not base their premiums on preexisting medical conditions. The two key issues that insurers care most about are whether the administration will enforce the individual mandate and whether the payment of cost sharing subsidies will continue.

ROVNER: Well, these are the tax credits that we've been hearing so much about.

In an interview with The Wall Street Journal on Wednesday, Trump suggested he is willing to cut the federal funding for cost sharing reductions (CSRs), which House Republicans have challenged in a lawsuit.

Obamacare may not have always been well liked, but it has gotten the job done.

HHS will make changes to the individual insurance marketplace to prevent insurers from leaving the Obamacare exchanges or raising insurance premiums next year.

Three of the five national insurers have significantly reduced their plan offerings this year. And Humana on February 14 said it wouldn't participate in any exchanges in 2018, in a statement also noting that the current environment "creates uncertainty for Humana's businesses". If concessions to conservatives in the deal lead to enough moderates to back away from the measure, the president said he's not ruling out working across the aisle on a plan. Without the subsidies, insurance could get very expensive in some places in the country.

In case you missed it, last week saw the debut of Trumpcare. As such, insurance companies shouldn't look at that part of the rule as an assurance that the money will be paid, according to Edmund Haislmaier, a senior fellow at the Heritage Foundation. Bronze plans, for example, now must cover an average of 60 percent of costs, while a silver one is 70 percent.

This penalty was created to coerce younger, healthier adults to enroll. If you're going to force insurers to cover sick people, then you have to force healthy people to sign up too so that premiums don't explode. With insurers no longer allowed to deny coverage to patients with preexisting conditions, they're clearly dealing with some degree of adverse selection. They didn't want the idea of people getting thrown in jail for not having health insurance. Those who receive the most generous financial help could expect to be on the hook for $1,700 more if plans next year passed on those costs to consumers. Particularly hard-hit would be couples who were uninsured previously because they could not afford health insurance as singles or could not get it under their state's Medicaid rules.

And yet, quite a few young adults who didn't buy health insurance also didn't pay the penalty. In previous years, they had twice that much time, and could still buy coverage until January 31. Second, it is possible that replacement health insurance policies will not contain all the benefits and services now mandated by ACA regulations and statute, so benefits such as prevention, screening for disease, payments for expensive treatments and/or mental health services may not be covered in many policies. While this could lower premiums for some, it would increase enrollees' out-of-pocket costs. The OIC would act as the arbiter that would require a valid explanation for double-digit percentage premium increases and decreases. The conservative group Judicial Watch, which has been tracking the cost of presidential travel for several years, estimates that President Trump's frequent visits to his Palm Beach resort Mar-a-Lago probably cost the government around $1 million each.