Dive Brief:
- From raising premiums to exiting the exchange marketplaces, health insurers are rethinking their ACA participation in various ways as uncertainty about the future of the healthcare law mounts, according to a new study from the Urban Institute with support from the Robert Wood Johnson Foundation.
- The study queried insurance officials of 13 companies participating in ACA markets in 28 states about how they would respond to an immediate repeal of the law, a "repeal-and-delay," and a mid-year cutoff of cost-sharing subsidies for low-income enrollees.
- While the insurers are largely committed to the market in 2017, they had serious reservations about remaining in it for 2018 if the law is repealed with out an effective replacement.
Dive Insight:
The interviewed insurers don’t like the idea of a "repeal-and-delay" because it would destabilize the individual market. Eliminating the cost-sharing subsidies would hurt insurers’ bottom line and cause them to exit the market “as quickly as state and federal law would allow." Insurers also said that uncertainty could force them to raise premiums, particularly if the individual mandate is eliminated.
In South Florida, with 39% of ACA enrollees in the state, the prospect that uncertainty will lead to higher premiums should concern consumers, the South Florida Business Journal reports.
“Most of the insurers we interviewed had not anticipated the election outcome and, just a few weeks after the election, were still assessing the range of potential policy changes they could face in 2017 and beyond, as well as the impact on their companies,” the study notes. “However, all of them are still actively selling their plans to consumers via the ACA’s marketplaces and remain committed to these markets at least through the current year.”
Some insurers aren’t waiting for lawmakers’ repeal-and-replace scenario, but are offering their own ideas on how to structure a post-Obamacare world. Their recommendations include more emphasis on the individual mandate, retention of cost-sharing and premium subsidies, and limitations on special enrollment periods.