The demise of the American Health Care Act (AHCA) has left payers uncertain about funding for cost-sharing subsidies and reinsurance payments as a June deadline to submit initial plan designs and rate suggestions approaches, The Wall Street Journal reported.
"Rather than play pin the tail on the donkey with nine-figure decisions, most would probably opt not to participate," John Gorman, a health insurance consultant and former official with CMS, told Axios.
- The executive branch could act independently of Congress to improve functionality of individual insurance exchanges, but the Trump administration may remain hands off to improve its position politically, Vox reported.
A shadow of doubt has been cast over Affordable Care Act insurance exchanges since Republicans rode promises to repeal and replace the 2010 health law to a majority in Congress and control of the White House. However, early efforts to implement healthcare reform have stalled without delivering answers on insurance exchanges.
There were issues with insurance exchanges even when President Barack Obama was doing everything possible from the Oval Office to keep them functioning as smoothly as possible. Too few young and healthy patients signing up for health plans has been one problem plaguing payers on the exchanges. Legal battles over funding for payers to entice them into exchanges has been another.
For now, it does not appear that the Trump administration will go to great lengths to keep the insurance exchanges running. For instance, the Trump administration has already ceased a marketing campaign intended to promote enrollment in insurance exchanges this year. President Trump has indicated he might be willing to ignore insurance exchanges and let them fail on their own. “The best thing we can do politically speaking is let Obamacare explode,” he has said.
On the other hand, President Trump did issue new rules earlier this year intended to maintain stability in insurance exchanges. He has also more expressed willingness recently to work with Democrats on healthcare reform, although his remarks included a shot at the 2010 health law many of them supported.
The Democrats will make a deal with me on healthcare as soon as ObamaCare folds - not long. Do not worry, we are in very good shape!— Donald J. Trump (@realDonaldTrump) March 28, 2017
Unless the Trump administration takes action to assure payers that participation will be worth their while, more may drop out. Humana has already announced that it will not participate in exchanges next year. If this occurs, the cost of health plans sold on insurance exchanges will likely go up and patients will have fewer choices available to them.