Echoing recommendations from the industry’s largest trade group, health insurance executives are urging Republicans to keep the individual marketplaces from collapsing while they repeal and replace the Affordable Care Act.
America’s Health Insurance Plans recently outlined its suggestions to keep the exchange markets stable, which include extending the timeline for health plans to file their marketplace products for 2018 and continuing to fund cost-sharing reductions and reinsurance until 2019.
Donald Trump’s administration and Congress also should keep insurers updated on their plans, given that they must plan so far in advance, Alan Murray, CEO of CareConnect, the insurance unit of New York’s Northwell Health, told The Wall Street Journal. Insurers need to know the ground rules in order to make business decisions for 2018, he said.
Yet Michigan-based Priority Health is engaging in “scenario planning” for what the company predicts will be a variety of possibilities, CEO Joan Budden said.
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Other executives have even less optimistic predictions. Molina Healthcare Chief Executive Mario Molina told the WSJ that he could envision a situation in which no insurer will want to operate in the ACA exchanges. And Kirk Zimmer, executive vice president at Sanford Health Plan, noted “we’d have a difficult time staying in the marketplace with the elimination of subsidies or the elimination of the individual mandate.”
An ACA repeal done through budget reconciliation could indeed end both of those ACA provisions, notes a recent report from the left-leaning Center for American Progress, which calls them “essential carrots and sticks” that keep the marketplaces afloat. Thus, even a partial ACA repeal—which Senate Majority Leader Mitch McConnell has said will be an early priority for Republicans—could increase the number of uninsured Americans to 58.7 million by 2019, according to another analysis.