As the future of our nation’s healthcare grows ever more uncertain, insurance commissioners are doing everything they can to keep insurers from leaving their states.
“As a regulator, instead of being rigid on timelines, the type of pricing I’m going to want, I’m being more open about this,” said New Mexico insurance superintendent John Franchini.
Deadlines for insurers’ premium requests are fast approaching, and they have until June 21st to tell the federal government whether they will participate in ObamaCare in 2018.
But insurers are nervous about the Trump Administration’s indecision about whether to continue federal payments that compensate insurance companies for subsidizing out-of-pocket costs for low-income consumers.
GOP lawmakers passed the American Health Care Act in May, but even if this bill makes it through the Senate, we still don’t know whether the government will continue to fund the cost-sharing subsidies that help many individuals pay for health insurance.
Insurers want Washington to confirm they will continue to receive cost-sharing payments from the government – which in 2017 will amount to about $7 billion – but such a promise seems unlikely.
Meanwhile, commissioners’ biggest fear is that every carrier will exit the market, leaving consumers with no ObamaCare options. Some states, like Iowa and Oklahoma, are already down to a single insurer when it comes to subsidized coverage.
“I don’t have any leverage to tell a health insurer they have to stay in the market,” argues Washington state insurance commissioner Mike Kreidler. “The GOP is scaring the bejesus out of them, and I’m trying to calm things down and work it out.”
It’s easy to see that the ACA’s insurance marketplaces are in a death spiral, but some Democrats believe the GOP is purposely trying to make ObamaCare collapse. Amid the partisan fighting, insurers don’t know what to plan for.
Pennsylvania’s five insurers have filed premium increases averaging about 9%, but that increase could rise to 36% without cost-sharing payments from the feds and the ACA’s individual mandate to purchase insurance.
BlueCross BlueShield of North Carolina increased on- and off-exchange plans by over 20%, but said rates would go up by less than 9% if cost-sharing payments could be guaranteed.
BlueCross BlueShield of Kansas City and Aetna have decided to completely leave the ObamaCare individual insurance market after losing $100 million and $700 million (respectively) since 2014.
UnitedHealth Group and Humana have also exited most of the government-subsidized individual health insurance market.