Trump looks to stabilize health insurance market
Goal is to soothe jittery insurance companies.
Worried about the nearly 20 million people who buy their own health insurance policies, the Trump administration and congressional Republicans are weighing how to stabilize a market made wobbly by the threatened repeal of the Affordable Care Act, government and industry officials say.
The goal is to soothe jittery insurance companies that may bolt from the program next year while reassuring anxious consumers. That could also buy time for more ambitious GOP attempts to rework the Obama-era health care law.
Some of the changes can be carried out the new administration alone, but others would require congressional action or cooperation.
The measures would affect not just those consumers on the subsidized marketplaces under so-called “Obamacare,” but also people purchasing directly from insurers or through an independent agents and who are not eligible for financial assistance from the government.
A Republican congressional aide familiar with the internal discussions said the regulatory changes that the administration is considering include:
Tightening rules for “special enrollment periods” that allow consumers to sign-up outside of the standard open enrollment window. Insurers have complained that some people take advantage of such opportunities to get coverage when they need care and later drop out, raising costs for everyone else.
Loosening a provision of the Affordable Care Act that prevents insurers from charging older customers more than three times the premium for young adults. Before the health law, insurers routinely charged older customers five times or more what younger people paid. The ACA has made insurance more affordable for older adults, but critics say that’s pricing out the young and healthy.
Shortening the current health law sign-up season, which runs about 90 days.
Relaxing rules on how insurers structure their networks of hospitals and doctors. Republicans tend to think those should be set by states.
The proposed changes mirror requests by insurers, who argue they would help check premiums. Last week, major insurers Anthem and Aetna said they are assessing their participation for next year. Anthem spelled out changes it would like, including some on the administration’s list.
Along with the administration, congressional Republicans would have a role to play in stabilizing the markets, by stepping back from several previous efforts to block “Obamacare” financing.
Chief among them is the fate of billions in subsidies that help low- and moderate-income people cover high insurance deductibles and co-payments. More than half of the consumers in the government marketplace get these subsidies.
After promising to quickly shred Obama’s law and replace it with a conservative approach, Republicans seem to be slowing down and thinking things over.
The nation’s uninsured rate has fallen to a historic low of about 9 percent under the Affordable Care Act, and Democrats are putting Republicans on notice that they’ll be blamed if people lose coverage or benefits such as protection from being denied insurance because of a medical problem.
That warning isn’t lost on House Energy and Commerce Committee Chairman Greg Walden, R-Ore. At a hearing last week, the powerful Republican said the country isn’t going back to the days when “through no fault of your own (if ) you have some disease that keeps coming at you ... sorry, you’re on your own and you’re destitute.”
“That’s not the choice here,” said Walden. “The choice is how we get it right.”