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Health Insurers Face 'Massive Confusion' As GOP Wavers On Obamacare
NPR ^ | 2-9-17 | Jay Hancock

Posted on 02/10/2017 9:44:40 AM PST by outinyellowdogcountry

Premiums for Obamacare plans sold by New Mexico Health Connections could rise as little as 7 percent next year, said Martin Hickey, the insurance company's CEO. Or they might soar as much as 40 percent, he said.

It all depends on what happens in Washington. Such is the vast uncertainty about how the Trump administration and Republican-controlled Congress are approaching their promises to repeal, repair and replace the Affordable Care Act, also known as Obamacare.

There is "pretty massive confusion," said Hickey, whose 45,000-member plan is one of the few nonprofit insurance co-ops created by the ACA to still be in business. "The more uncertainty they create, the higher the rates" will be for 2018, he said. Trump, GOP Lawmakers Back Off From Immediate Obamacare Repeal Shots - Health News Trump, GOP Lawmakers Back Off From Immediate Obamacare Repeal

Insurers have a hard enough time making the normal predictions of who will get sick and how much care will cost. Now the usual fog of rate setting is compounded by the possibility that basic rules of coverage could get overhauled or even disappear before anything takes their place.

Consumers and patients could ultimately pay the price.

The stakes include how much plans sold through the health law's online marketplaces and similar coverage will cost in 2018 — or even whether insurance will be available. Challenges during the recently completed enrollment period, in which some carriers canceled plans and rates rose 20 percent on average, increase the urgency, executives say.

"This is nothing less than a nightmare scenario for the carriers," said Robert Laszewski, a former insurance executive and consultant who works with large plans. "The Republicans don't seem to understand that they've got to stabilize the market."

Coverage for 2017, which has already been finalized, won't change. People covered through job-based insurance or the private Medicare plans for seniors won't be much affected by the uncertainty.

In some states, preliminary 2018 rates are due in less than two months. But prospects for policymaking clarity recede each day that Republicans deliver contradictory messages or fail to agree on a plan, industry officials say.

While some in the party want to go slow on an overhaul and ensure they've thought out a replacement before abolishing the health law, others favor immediate repeal.

If the administration and Congress scrap the ACA's coverage requirement for most people or its subsidies helping people buy care, the market could deteriorate or collapse, say insurance consultants and executives.

A month ago President Trump told The New York Times that Obamacare is "a catastrophic event," adding, "we have to get to business" in repealing it. On Feb. 5, he seemed to advocate a more measured approach, telling Fox News that "at least the rudiments" of a replacement would be in place by 2018. Employers Fear GOP Health Overhaul Could Damage Job-Based Insurance Shots - Health News Employers Fear GOP Health Overhaul Could Damage Job-Based Insurance

Even that could spook insurance executives contemplating plans for next year in the Obamacare marketplaces, also known as exchanges. They want to know the rudiments of a replacement plan now and details not much later.

"I don't think there's a real clear path to repeal or replace or repair or anything," said Kevin G. Fitzgerald, an insurance lawyer with Foley & Lardner. "Some of our clients will probably move forward on the assumption that something will happen to maintain the exchanges more or less the way they are. Others may pull out early."

Big, national insurers have said it would be hard to commit to the marketplaces next year unless they get a much better idea of what they'll look like.

Several had already scaled back coverage for this year, leaving many parts of the country with only one company selling through the marketplaces. Continued uncertainty could prompt even those holdouts to bail, said Fitzgerald.

"If in those states those carriers decide, 'We've lost enough and we're going to sit this year out,' there are no exchanges," he said. "And that certainly is a possibility."

The Trump administration has proposed regulations, initiated in the last days of the Obama regime, intended to steady the market. Tweaks may include crackdowns on sick consumers who join plans outside open-enrollment periods and allowing insurers to charge slightly more for older members, Huffington Post and Politico have reported.

Those changes — plus assumptions that Republicans will eventually have a replacement plan helping Obamacare patients maintain coverage — could reassure insurance companies, said Dan Mendelson, CEO of Avalere Health, a consulting firm.

"I'm not saying it would be completely pain-free," he said. "You probably would see some plans get out of the market. But if plans start to believe there's a long-term solution, they're going to want to stay in because getting in and out of the market costs money."

What industry really wants is certainty government will continue helping consumers pay for coverage — one of the most contentious and uncertain aspects.

For two years the Republican-controlled House of Representatives has legally challenged one type of subsidy — federal payments to reduce out-of-pocket costs for lower-middle income consumers. The Obama administration defended the subsidies in court, but insurers worry that Trump officials could drop the defense or that a judge could declare the payments illegal.

Industry interest in the suit "is incredibly high," said Todd Van Tol, a partner with Oliver Wyman, a consultancy with many insurers as clients. The disappearance of those subsidies, he said, "would likely trigger a fairly significant insurer pullback in fairly rapid order."

Even the most publicly minded insurers might cease offering individual Obamacare plans if an uncertain market threatened their financial stability, said Ceci Connolly, CEO of the Alliance of Community Health Plans, a trade group of nonprofit carriers.

"We want to be able to do this, but if there's potential for significant losses it would be irresponsible to maybe do it," she said. "There seems to be a growing recognition of the challenge ahead and also the need for stability, but boy — this clock is coming up fast."


TOPICS: Business/Economy; Government; News/Current Events
KEYWORDS: 0carenightmare; aca; healthcareinsurers; obamacare; repealandreplace
The comments from NPR readers are whacked out. For those of you who care to engage, venture on over there and tell them real world stories. No wonder my otherwise smart and kind family and friends are so liberal. That is the NPR crowd. I never listen to their news. They shouldn't be in the news business since they are really liberal advocates.
1 posted on 02/10/2017 9:44:40 AM PST by outinyellowdogcountry
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To: outinyellowdogcountry

LOL. Here comes the propaganda from the Left. The GOP is “wavering” and “scared” and may back off of changing Obamacare. So everyone is confused and the GOP has created a big mess. So they probably should just drop changing Obamacare and do something else. We have no idea what is going to happen next. Obamacare will be addressed during this legislative term. NPR and the other liberal media throwing these “chaos and confusion” story lines out now is pure propaganda.


2 posted on 02/10/2017 9:47:06 AM PST by Opinionated Blowhard ("When the people find they can vote themselves money, that will herald the end of the republic.")
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To: outinyellowdogcountry

I read it on Facebook and commented there. I clicked the laughing emoji but funny, it isn’t shown! About 3/4 or more down the page: https://www.facebook.com/NPR/


3 posted on 02/10/2017 9:48:28 AM PST by outinyellowdogcountry
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To: outinyellowdogcountry

I can’t wait ‘till President Trump pulls their federal funding.


4 posted on 02/10/2017 9:48:44 AM PST by V_TWIN
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To: outinyellowdogcountry

It’s part of the strategy. Wait another few months and let choice diminish and prices increase. The system will kill itself and there will be no question of its failure.


5 posted on 02/10/2017 9:49:00 AM PST by struggle (The)
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To: outinyellowdogcountry

RINOs are now the main [problem with getting rid of it - they did all them useless votes that hadn’t a chance over the years and now that they have the power, they stick their heads back up their own butts.


6 posted on 02/10/2017 9:49:33 AM PST by trebb (Where in the the hell has my country gone?)
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To: outinyellowdogcountry
There is "pretty massive confusion," said Hickey, whose 45,000-member plan is one of the few nonprofit insurance co-ops created by the ACA to still be in business.

There is ZERO confusion for the millions of people who voted for Trump to repeal (and replace) Obamacare.

7 posted on 02/10/2017 9:50:09 AM PST by olezip
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To: outinyellowdogcountry

HINT: If you work for an “exchange” better brush up your resume and send it to a private insurer.


8 posted on 02/10/2017 9:51:31 AM PST by 1Old Pro
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To: outinyellowdogcountry

Did NPR squawk about the confusion when the billion $$ Obamacare website went live but didn’t work? When people lost their insurance and doctors? No.

Therefore this current “confusion” is fake news - an NPR specialty.


9 posted on 02/10/2017 9:56:13 AM PST by bkopto
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To: outinyellowdogcountry

Frankly, screw NPR and its concern ninny listeners.

What a right-thinking insurance company ought to be betting on is a slate of offerings it can propose that won’t be limited to state lines, and won’t be limited to mandatory levels of coverage to provide baby killing coverage or all the feminine needs of potential clients and spread that cost over the whole group of people it could cover just wanting basic cost-effective coverage.

They should count on being able to provide a range of deductibles, coverage and cost options relying on the fact that GOVERNMENT cannot dictate the health choices of its constituents.

They should count on keeping bitches like Lena Dunham, Ashley Judd and that whoor so-called college chick who wanted free rubbers and whatever [we don’t even remember her name now] out of the process.


10 posted on 02/10/2017 10:02:14 AM PST by Gaffer
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To: outinyellowdogcountry

WOW - NPR is suddenly worried about the health of insurance companies!


11 posted on 02/10/2017 10:08:56 AM PST by aquila48
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To: outinyellowdogcountry

They didn’t care when a lot of people lost their insurance because they could no longer afford it after it was rammed through in the dead of night.


12 posted on 02/10/2017 11:28:57 AM PST by Trillian
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To: outinyellowdogcountry

NPR has gotten to be totally intolerable.

Thirty seconds of NPR is usually the max for me.

They are not alone - The Guardian and The New York Times have also fallen off my daily rotation.


13 posted on 02/10/2017 12:12:09 PM PST by Brian Griffin
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To: outinyellowdogcountry

Those people suffer from massive confusion as an ordinary component of each day.


14 posted on 02/10/2017 2:28:14 PM PST by GingisK
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