Expert weighs in on ACA woes
BeWellnm speaker blames Trump , Obama for insurance uncertainty
One of the nation’s foremost experts on the Affordable Care Act and healthcare reform was in Albuquerque on Friday to weigh in on the turbulent political climate that has been roiling insurance markets and plans for coverage in 2018.
Chris Condeluci, a Washington, D.C.-based lawyer who was a Republican staffer on the Senate Finance Committee when the ACA was drafted, was guest speaker at the beWellnm board of directors meeting. A small percentage of the state’s insured — about 55,000 New Mexico residents — signed up last year for coverage through the New Mexico Health Insurance Exchange, also known as beWellnm.
“The timing of Mr. Condeluci’s comments to our group, with the next open enrollment period approaching, complements the ongoing discussions in our nation’s capital,” said Dr. J.R. Damron, beWellnm board chair. “Condeluci’s role in the development of the ACA and continued work in healthcare reform provide great insight for beWellnm’s leadership.”
A key question for nervous insurers is whether Congress will agree to fund cost-sharing reduction subsidies before insurers must file their plans and rates for 2018. The deadline for filing is Sept. 27.
Fueling the uncertainty have been congressional efforts to repeal key portions of the ACA and the Trump Administration’s ongoing refusal to commit to the subsidies.
About 60 percent of those on the New Mexico exchange qualify for subsidies that reduce costs. Insurance companies receive their cost-sharing subsidies to defray the cost of premiums for those low- to moderate-income clients.
Participating New Mexico insurers have received approval to hike rates an average of 36 to 41 percent for the coming year. The state’s insurance superintendent said the record-setting rate increases in 2018 are heavily influenced by uncertainty about whether the federal government will block or discontinue subsidies.
Condeluci said the Trump administration must take some of the blame for the recent premium increases, due in part to the president’s repeated comments that the ACA is imploding and his insistence that it be repealed. But Condeluci also believes the way the Obama administration implemented the ACA caused many of the current market woes, with fewer healthy people signing up for coverage. That leads to higher premiums and carriers exiting this line of business.
The rate hikes in New Mexico factor in the possibility that the subsidies will end.
That could mean a windfall for insurers if the subsidies remain in effect. In that event, Condeluci said, state regulators and insurers might have “to do a pivot” to retroactively lower rates. That, he said, would add even more chaos.
A Molina Healthcare spokeswoman said Friday the insurer is willing to re-adjust. Molina serves about 37 percent of Obamcare enrollees in New Mexico.
“If we get confirmation at the national level that the individual cost-sharing reductions will be funded in 2018, Molina will work with beWellnm and the superintendent of insurance to adjust rates to reflect cost-sharing reduction funding,” she said.