Health insurance companies, including Independence Blue Cross and Molina Healthcare, are providing recommendations on how to structure a plan for replacing the Affordable Care Act (ACA), Reuters reports.
The insurers are emphasizing more the individual mandate, retention of cost-sharing and premium subsidies and limitations on enrollment outside of the regular enrollment period.
J. Mario Molina, CEO of Molina Healthcare, would not commit to offering ACA plans next year, citing “too many unknowns.”
Some insurance companies are no longer waiting around for lawmakers to figure out the repeal-and-replace strategy on their own. After saying relatively little during the Trump administration’s transition period, they are beginning to push their own agenda during this window of opportunity. And at least one insurer, Molina, is hinting that if their advice isn’t heeded now, they might not play ball in 2018.
Unsurprisingly, one area of emphasis is the individual mandate, a sticking point throughout healthcare reform. Should it be eliminated, which is generally assumed to be one of the Republican’s goals, there will be little incentive for young, healthy people to enroll in insurance plans in order to offset older, sicker members.
Unless insurance companies can make the premiums more enticing to healthy people they won’t be able to find that balance. Avalere Health’s CEO, Dan Mendelson, mentions making it “free or close to free.”
Subsidies are also key, and it’s one thing that consumers, payers, and many experts agree upon. Keeping the subsidies in place will help stabilize the individual market and further encourage younger people to sign up. While still a somewhat small piece of the pie, the individual market is also an area of opportunity for plans – if they can make it profitable.