Obamacare deadline arrives, yet insurers can still drop out
Uncertainty in Washington stokes providers’ fears
A relative newcomer to health insurance intends to enter or expand on the Affordable Care Act exchanges in five states at today’s filing deadline, improving the outlook for Obamacare but hardly eliminating the grave threat Trump administration-spawned uncertainty poses.
Oscar Health, started in 2012, joins insurer Centene which last week announced plans to sell ACA plans in Kansas, Missouri and Nevada and to expand in six other states. The news comes as even insurers that have announced their plans to sell ACA plans publicly reserve their right to change their minds.
“We intend to participate but we will continue to monitor for changes at the federal level that could impact our decision on whether to sign the agreement in September,” said Mary Danielson, a spokeswoman for Blue Cross Blue Shield Tennessee (BCBST).
The company was the first to file to sell 2018 plans in Tennessee and will sell individual insurance in most parts of the state, but not the greater Memphis and Nashville areas.
Independence Blue Cross CEO Daniel Hilferty said that even though he considers his company to be “the insurer of last resort” in several counties around Philadelphia, he told his board it may have to pull out if the picture in Washington without certainty about funding of the cost-sharing subsidies and enforcement of the individual mandate.
“For the first time, this has to be wait and see,” says Hilferty. “We need adults to get in a room that are willing to look past politi- cal ideology and develop a program that meets the needs of as many Americans as possible.”
The Trump administration has refused to commit to reimburse insurers for the subsidies about 7 million consumers get to defray the costs of deductibles and other cost sharing. It also is not clear that it will enforce the ACA-mandated tax penalty for those who don’t have health insurance. Without that assurance, insurers fear they won’t get enough healthy people to sign up to offset the cost of insuring the sick.
Actuaries at the health consulting firm Oliver Wyman esti- mated last week that two-thirds of the rate increases in 2018 are because of this uncertainty, while ACA supporters including Charles Gaba of ACASignups.net say it’s a major reason for the insurer exits. Hilferty says Democrats share some of the blame.
President Trump has suggested the indecision could push Democrats to support the ACA replacement plan being considered behind closed doors in the Senate. But that strategy may be backfiring, a study by the University of Maryland’s Program for Public Consultation shows. All of the key provisions of the Housepassed American Health Care Act are opposed by clear majorities.
Overall, nearly 70% of 2,430 registered voters surveyed oppose the legislation and more than 60% were against it even in very Republican districts.
“We need adults to get in a room that are willing to look past political ideology and develop a program that meets the needs of as many Americans as possible.” Daniel Hilferty, Independence Blue Cross CEO