Q: What’s the like­li­hood of main­tain­ing a vi­able in­di­vid­ual in­sur­ance mar­ket in the next sev­eral years?

Modern Healthcare - - NEWS -

Mar­i­lyn Taven­ner:

“It’s the in­di­vid­ual mar­ket and it’s also Med­i­caid ex­pan­sion. Both are im­por­tant to in­sur­ers.

“There are some im­me­di­ate things that need to hap­pen. This whole is­sue of cost-shar­ing sub­si­dies. … So our first mes­sage has been that the Repub­li­cans will need to agree to ap­pro­pri­ate fund­ing for the cost­shar­ing sub­sidy be­cause with­out that fund­ing peo­ple will likely exit the in­di­vid­ual mar­ket. Then we’re back to the in­di­vid­ual mar­ket only be­ing those who can pay high pre­mi­ums with­out sub­si­dies.

“The in­com­ing ad­min­is­tra­tion and the Repub­li­cans who ran for re­peal and re­place also said they didn’t want to see peo­ple lose cov­er­age. So you’ve got to sync up those two things.

“The same thing is true in Med­i­caid ex­pan­sion. All the gov­er­nors and in­sur­ance com­mis­sion­ers are say­ing what we need. But the most im­me­di­ate thing for us is go­ing to be the cost-shar­ing sub­si­dies so we can keep the in­di­vid­ual mar­ket. With­out that, it’s go­ing to be dif­fi­cult for in­sur­ers to price, and that will im­pact physi­cians and hos­pi­tals be­cause they won’t know what the sta­tus of their con­tracts are go­ing to be.”

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