Uncertainty for insurers
Republicans look to resuscitate a policy after their bill was withdrawn lastweek.
washington » Colorado Republican U. S. Rep. Ken Buck on Wednesday said he wants to see the GOP’s left- for- dead health care overhaul resuscitated for a vote within the next month, while a health care consultant warned that the lingering uncertainty around national health policy will probably scare evenmore insurers away from the coverage exchanges.
The comments are a sign that the storm clouds looming above the Affordable Care Act won’t be blowing over anytime soon, despite the failure of congressional Republicans to move forward last week with their national health care plan. The Trump administration could take steps to significantly alter how the act, also known as Obamacare, is funded, promoted or enforced. Republicans in Congress could try to push a new for major changes to the law. Conservative activists could punish them if they don’t.
And insurers, spooked by the turmoil, could raise rates or bolt for the door.
“The greatest enemy for insurers is uncertainty,” said Karen Pollitz, a senior fellow at the health policy- focused Kaiser Family Foundation. “It just makes it very hard to project what your costs will be and who will participate in the market.”
The Republican plan — released three weeks ago as the American Health Care Act— would have eliminated the requirement that people buy health insurance, cut back on Medicaid spending and changed how tax subsidies are distributed for those buying plans on their own. Over a decade, it would have trimmed federal spending by hundreds of billions of dollars, while leaving 24 million more people uninsured than therewould be under the current law.
The plan appeared to collapse last week, when Republican leadership in the House could not get enough votes tomove it forward and withdrew the bill. But some Republicans have been talking about trying again, and Buck, who lives in Windsor, on Wednesday added his voice to the group.
“It’s got to get out of the House before the April break or soon after the April break in order to get it through the Senate,” Buck said. “I don’t think anybody wants to see this health care process last much longer than May.”
May also is a crucial deadline for the insurance industry, which that month must submit its 2018 plans to the Colorado Division of Insurance for approval — although a division spokesman Wednesday said the deadline will probably be pushed to June.
Charlie Sheffield, the executive director of the Colorado Association of Health Plans, said he has not heard of any insurers planning to pull out of the state’s Affordable Care Act exchange next year. A spokeswoman for Kaiser Permanente, one of the state’s largest insurers, confirmed that the company expects to offer plans on the exchange in 2018.
But Pollitz and others said the federal uncertainty could greatly affect the plans customers see when they go shopping. About 8 percent of Coloradans buy their plans through the individual market.
Even if Congress doesn’t make changes to the Affordable Care Act, the Trump administration might. For instance, the administration could back off enforcement of the mandate that people buy health insurance— providing incentive for more healthy people to go without coverage and skewing insurers’ finances.
Most significantly, the administration could also stop fighting a lawsuit challenging the funding for a $ 7 billion government program that helps pay the deductibles of low- income people who otherwise probably couldn’t afford insurance.
The signals from Congress and the White House could be enough to cause premium spikes or scare off insurers.
“I think people need to brace for the likelihood that we’re going to have more market exits,” said Mara Baer, a Colorado- based health care consultant.
But, politically at least, leaving the status quo in place won’t be friendly to Republicans in Congress.
Before Friday’s failure, Colorado Republicans said they strongly favored efforts to both repeal and replace the Affordable Care Act. Margo Knutson, who runs the group Coffee 4 Conservatives in Douglas County, said her fellow activists were split in their reaction to what happened lastweek.
Knutson said some sided with the Freedom Caucus, the hardline conservative group that sunk Republican efforts to put a repeal bill on the House floor because it didn’t go far enough. Others, she said, wanted to see the GOP bill go forward because thatwould at least get the ball rolling.
Either way, “I was disappointed that we didn’t have a plan after this many years,” Knutson said.
The comments by Buck and others show the interest is there to try again. On Wednesday, Buck — who previously would not reveal his position on the GOP bill — said hewas a “yes” on the measure.
U. S. Rep. Scott Tipton, R Cortez, also refused last week to say how he would have voted on the bill. In a statement, he said he supports parts of the bill, like ending the individual mandate, but is also concerned about how the new tax structure could impact seniors. Right now, Tipton said the “Republican conference is nowin a regrouping phase to determine the best path forward.”
But the path forward will be difficult. House conservatives, who want to end the Affordable Care Act as quickly as possible, must contend with lawmakers such as U. S. Sen. Cory Gardner, R- Colo., who has raised concerns about the speed in which some Republican plans would eliminate an expansion of Medicaid, which has provided insurance to 407,000 more Coloradans.
For one top Colorado Republican, however, the whole episode is a sign his party needs towork harder.
“It’s a definite black eye for Republicans,” said Robert Blaha, Trump’s Colorado campaign chairman. “Republicans need to learn how to govern and they need to learn how to lead and they need to knowhow to do something else other than say no.”