Republicans mull ways to prop up insurers after ACA repeal

Worried that health insurer exits will collapse the individual marketplaces before Republicans can implement an Affordable Care Act replacement, GOP congressional staffers are reaching out to insurers to help them devise policy fixes.

In their talks with the staffers, insurers are making their concerns about the individual market clear, three Republican lobbyists told The Hill. Indeed, citing ongoing losses, Aetna, UnitedHealth, Humana and some Blue Cross Blue Shield plans have pulled out of some markets, sparking concerns about limited competition on the exchanges. Others, like Anthem, have signaled they may follow suit.

GOP leaders are aiming to repeal the law in early 2017, but delay when that takes effect for up to three years to ensure they have time to put in a replacement and avoid disrupting coverage for millions of Americans, according to Politico. But that plan won’t work if the exchanges can’t remain viable in the interim.

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Still, it would be politically risky for Republicans to enact insurer-friendly policies, The Hill article says, as they have been highly critical of “bailouts” to the industry. GOP lawmakers have slammed the possibility that the government might settle insurers’ lawsuits over risk-corridor payment shortfalls, saying they are concerned funds would be illegally deployed to help insurers recover their losses.  

“They want to pump money back in to the insurers without appearing like they’re giving them a handout or bailing them out,” one lobbyist told The Hill. 

A more likely route, the article notes, might be for the Department of Health and Human Services to enact regulations favorable to insurers once Donald Trump takes office, such as tweaking how risk-adjustment payments are calculated. Some smaller insurers have alleged the current formula is unfair, and a few have even filed lawsuits.

Regardless of what route they choose to take, Republicans may face an uphill battle in their efforts to repeal and replace the health law while protecting consumers. “The flaws in Obamacare are obvious to me. The solutions are much harder,” Sen. Lindsey Graham, R-S.C., told Politico.