dglobalnews.com Insurers say Trump must do more to stabilize 'Obamacare'
Published: Sat, April 15, 2017
National | By Glenda Ortiz

Insurers say Trump must do more to stabilize 'Obamacare'

"But what really comes as a big surprise to nearly everybody is that that's not where Medicaid spends most of its dollars". Insurers, doctors, hospitals and the business community have asked President 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.

Marilyn Tavenner, president and CEO of America's Health Insurance Plans, the trade group representing health insurers, said in a statement "there is still too much instability and uncertainty in this market". The specific issue that insurers and the president are focused on at the moment are cost-sharing reductions, payments to health insurers that help reduce the deductibles and co-pays for 7 million Americans.

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.

A much tighter sign-up deadline and coverage delays will be waiting for some health insurance customers now that President Donald Trump's administration has finished a plan created to stabilize shaky insurance markets. By making such a change, the groups argue, the Trump administration violates a key part of the health law that requires insurers to offer coverage to just about everyone who applies.

The Trump administration released limited fixes Thursday for shaky health insurance markets, even as it reaffirmed its goal of dismantling the Obama-era law that created them and now covers millions.

If they stopped making payments immediately, I don't think insurers would continue to participate through the remainder of this year, because they would take substantial losses. Trump has threatened to withhold the payments as a means to force Democrats to negotiate on health care legislation.

The final rule, to be published in the Federal Register next week, saysconsumers who want to sign up for an ACA plan with their same insurer for 2018 would have to repay past-due premiums from the previous 12 months before being granted new coverage. Insurers say a person with a bad knee, for example, might enroll and pay just long enough to get an expensive knee replacement, then stop paying premiums. These are separate from the better-known so-called premium subsidies that most customers receive. Also based on those comment letters about the proposed rule, insurers also want a surcharge for people who let their coverage lapse and the permission to charge older people five times more than younger ones, a practice known as “age rating.” The current limit is 3:1.

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.

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Most communities will have competing insurers on their public marketplaces next year, but a growing number will be down to one, and some areas may face having none.

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. Companies are considering leaving more markets for next year because they say they are losing money.

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 says growth in underlying medical expenses could drive coverage prices up another 10 percent or more.

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.

Meanwhile, the legal issue over the cost-sharing subsidies also remains in limbo. The case is on hold.

These payments were explicitly included in the health care law, but through the convoluted quirks of legislative procedure, Republicans have alleged that Congress technically didn't "appropriate" money for the program.

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