News Worms
News Worms


Insurers say Trump must do more to stabilize 'Obamacare'

Insurers say Trump must do more to stabilize 'Obamacare'

Republicans say their bill would return control of health care to the states and restore the free market. So the administration is trying to keep the existing system going temporarily as it pursues a total remake. In most of those states, the expansion took effect in 2014, when the online health insurance exchanges also went live. While opening day would remain the same - November 1 - the final rule closes the marketplace on December 15 instead of at the end of January.

The smaller enrollment window could be tough on some shoppers because they often have to search for an insurance plan that includes their doctor to avoid big medical bills. All of these changes are aimed at increasing the insurers' revenue stream. So, basically, the IRS can deduct what you owe in health insurance tax credits from any tax refund you have coming overall, but they can't send people after you for money the way they can if you don't pay your regular taxes.

"It's a very delicate subject when you're dealing with someone's health and if the plan doesn't work, you're stuck with it for the next year", said Dallas-based broker Tanya Boyd. The ACA allowed a 90-day grace period before consumers could be kicked off their plans for non-payment. Insurers say these have been too easily granted, allowing some people to sign up only when they need costly treatment. Consumers will have to provide documentation proving they qualify for special enrollment before getting coverage. The new federal rule, however, creates an unnecessary barrier to maintaining insurance coverage. Ceci Connolly, president of the Alliance of Community Health Plans, said that if the funds were to go away, the nonprofit insurers that her group represents have said they would either have to make a hard decision about staying in the market at all, or hike premiums anywhere from 7 to 21 percent. (It exempts certain silver plans for low-income consumers from the change.) So, for example, a bronze plan might cover only 56 percent of costs and silver 66 percent. First, the ones that still remain in the individual exchanges have to decide whether to submit their 2018 plan designs and premiums by May 23. In response, the Obama administration tightened some of these requirements previous year and announced it would run a pilot program starting this summer to randomly select half of all special enrollment applicants for verification review, holding up the applicant's insurance coverage until they provide the proper documentation.

The final rule upholds much of what was proposed by the administration in February, including a shorter enrollment window, tighter vetting of people who sign up outside of those open periods and efforts to require some consumers to show proof of prior insurance coverage.

"It did do a tremendous amount of good, but we need to take one step back to realize that there were 3,300 registered health care lobbyists for the 535 members of Congress, and more was spent in the run-up to the Affordable Care Act than what was spent on the Bush-Kerry election", Song explains. But a key concern has yet to be addressed.

Estimated at $7 billion this year, the future of the cost-sharing subsidies is under a legal cloud. To encourage people to pay their insurance premiums, the rules require people to make up for missed payments before buying a new insurance plan, if they're purchasing coverage from the same company they had in the past.

"Obamacare is dead next month if it doesn't get that money", Trump said, referring to cost-sharing reductions. "I think I will get it done", Trump told The Wall Street Journal, adding he's not open to setting guidelines for Congress on tax reform without completing the Obamacare repeal first.

"I don't want people to get hurt", Trump said in the Journal interview.

Most communities will have competing insurers on the public marketplace next year, but a growing number will be down to one, and some areas may face having none. This year alone, premiums for ACA plans rose by an average of 25 percent.

Dave Dillion of the Society of Actuaries says growth in underlying medical expenses could drive coverage prices up another 10 percent or more.

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