Political malpractice

All across the country, health insurers are planning dramatic premium hikes for the Affordable Care Act — and our leaders in Washington, D.C., are to blame.

The Affordable Care Act remains the law of the land, for now. But health insurers have lost confidence in Congress and the Trump administration to execute a strategy for “repeal and replace” that will largely maintain coverage for the millions of Americans who have recently gained access to health care.

Aetna will completely withdraw from Affordable Care Act insurance exchanges in 2018, it announced Wednesday. Other insurers are requesting premium hikes as large as 53 percent.

Officials for California’s exchanges are currently remaining mum, citing negotiations with insurers for next year’s Covered California options. (Final rates will be released in mid-July.)

But Covered California’s own analysis showed that California’s premiums could rise anywhere from 28 to 49 percent in 2018, depending on the changes Congress and President Trump make to existing federal policies.

Covered California’s analysis, released at the end of April, cited a rise of “up to 49 percent” if Congress and President Trump changed two important elements of the Affordable Care Act: direct funding of cost-sharing reimbursements to insurance carriers and enforcement of the individual mandate.

Over the past three years, Covered California premiums have risen by an average of just 7 percent.

Without those two elements, the analysis found, up to 340,000 Californians would also lose their coverage in the individual market in 2018.

A bill passed recently by the U.S. House of Representatives repealed the individual mandate in exchange for allowing insurers to demand a continuous coverage surcharge. The Trump administration has repeatedly threatened to withhold the cost-sharing reduction payments in an effort to force Democrats to agree to a repeal of the current law.

Faced with such a climate of extreme uncertainty, insurers’ dramatic rate hike requests are understandable. But they would cause the collapse of many states’ exchange markets.

California has much to lose if Congress undermines a health care law that was working in this state.