Health changes likely before taxes

Negotiations to replace the Affordable Care Act are continuing — despite mixed signals from Washington — and a rewrite of the law will precede the planned overhaul of the tax code, an industry lobbyist told a Pittsburgh audience on Tuesday.

James Gelfand, senior vice president of health policy at the ERISA Industry Committee, a Washington, D.C.-based trade group, said Congress is under the gun to overhaul health care before moving on to the tax code.

Mr. Gelfand’s remarks came the same day that Seema Verma, administrator of the federal Centers for Medicare and Medicaid Services, had been scheduled to meet with health insurance executives anxious about participating in the ACA’s online marketplace in 2018.

“If they don’t come through, the consequences will be great,” Mr. Gelfand told members of the Pittsburgh Business Group on Health, a trade and education group.

“They have a lot of motivation to get a deal done,” he said.

Mr. Gelfand anticipated a public announcement as early as Wednesday about progress on a compromise that would replace former President Barack Obama’s signature 2010 health care law.

Mr. Gelfand was the keynote speaker at the business group’s legislative update forum held at the Pittsburgh Marriott City Center. His agency is the voice of big employers for employee benefits and compensation.

The Republican-crafted American Health Care Act, which was meant to replace the ACA, was withdrawn from the House of Representatives in March, a stinging loss for President Donald Trump, when it became clear the bill did not have enough Republican support to pass.

Withdrawal of the AHCA left Obamacare intact for now and the health insurance industry shaken about the future of the plan.

In meeting with Trump administration officials Tuesday, insurance executives were seeking reassurance about the future of the law, which is struggling in many parts of the country.

Twenty-one percent of government health insurance exchange enrollees would have access to plans just from one insurer, a Kaiser Family Foundation analysis predicted in 2016.

In recent weeks, Mr. Trump suggested that costsharing subsidies for enrollees and reimbursement for losses that insurers suffered in the early years of the Affordable Care Act could be bargaining chips in negotiating a compromise, but Mr. Gelfand dismissed the idea.

“I don’t think that’s real,” he said. “In Washington, there’s a real visceral fear of the collapse of the individual market.”

Pennsylvania health insurers have until May 22 to file plan proposals to the state Insurance Department for 2018 coverage.

At the Pittsburgh business group’s forum, state Insurance Department chief of staff Jessica Altman said Pennsylvania is working hard to keep health insurers participating in the exchange market, which UnitedHealthcare and Aetna left for 2017.

“We’re going to do whatever we can to keep them in the market,” Ms. Altman said.

“We’re all dealing with a lot of uncertainty.”