As Republicans begin the task of crafting an Affordable Care Act replacement, health insurance leaders are weighing in about what they’d like to keep, change and get rid of in the current law.
One such leader is Independence Blue Cross CEO Daniel Hilferty, who told Reuters that he’s been pushing for stricter restrictions on third parties that pay patients’ premiums and on special enrollment periods, priorities echoed by others in the industry.
What’s more, Hilferty said, insurers would like to play a more significant role in the enrollment process for individual marketplace plans rather than leaving it all in the hands of the state and federal exchanges.
But the health insurance industry wants some aspects of the individual market to stay the same, at least for now.
America’s Health Insurance Plans has urged the new administration to fund programs like cost-sharing reductions and reinsurance at least through 2018. Insurers also want the ACA’s premium subsidies to stick around, Molina Healthcare CEO J. Mario Molina told Reuters.
Backed up by President Donald Trump’s recent executive order, Republicans are likely to nix the ACA’s unpopular individual mandate, which levies a financial penalty on those who remain uninsured. But absent that mandate, policymakers must find a way to entice healthy individuals to buy insurance, Molina said, adding “it probably needs to be a combination of both an incentive and a penalty.”
For its part, AHIP has suggested incentives such as waiting periods for late enrollment, FierceHealthPayer has reported.
Another solution that some in the GOP have floated is bringing back high-risk pools, which allow insurers to offer lower prices for healthier enrollees. Many states had high-risk pools before the ACA, but Republicans’ updated version may not necessarily take a similar form, according to Dave Dillon, a fellow at the Society of Actuaries.