With the neck-and-neck presidential election less than a week away, health insurers are waiting with bated breath since their future is on the line.
If former Gov. Mitt Romney is elected, insurers' immediate celebrations likely will be diminished by the uncertainty of whether he has the ability to repeal the health reform law, reported the Associated Press.
Although he repeatedly promises to grant states waivers from the reform law, Romney doesn't have the power to allow states to ignore the law. Other steps taken to repeal or reduce reform could be blocked in federal court. And even if Romney chose to rewrite or issue new regulations, that process could take months or even years, NPR reported.
"So now we could be sitting here with reconciliation having stripped out all the money, on Jan. 1 every sick person in America is showing up, getting their guaranteed-issue health insurance, and it's just going to ravage the insurance pools, drive the cost of insurance way high," Robert Laszewski, an industry consultant and blogger, told NPR.
Even the Republican plan to use budget reconciliation to repeal the law, assuming they gain control of Congress, isn't a guaranteed method, particularly because of the time-consuming nature of the procedure. Plus, the budget process can't repeal certain reform provisions, including requiring insurers to accept people with pre-existing conditions.
A more plausible scenario could be that Romney reduces the reform law's scope and scale, including delaying all or some of the new requirements not yet in effect, Morningstar analyst Matthew Coffina, who tracks the health insurance industry, told the AP.
But that begs the question--what stays and what goes? "Everyone has sort of treaded water until the election--then we're go or no go," Laszewski said. "If Romney's elected, it's like--we don't know what's going to go or not. And it's just going to be one hell of a mess."
What's more, insurers already have invested considerable time, resources and money to complying with several reform provisions. There's no guarantee they will just walk away from all that effort. "There are a lot of dollars and a lot of staff time that's been put into place to make this thing operational," says G. William Hoagland, a former vice president in charge of public policy for Cigna.
Laszewski agrees insurers could find themselves between a rock and a hard place if Romney becomes president. "I spend a lot of time in executive offices and board rooms, and they are good Republicans who would like to see Romney win," he told the AP. "But they are scared to death about what he's going to do."