With continued uncertainty in Washington about the future of the Affordable Care Act, the two insurers left selling plans on Connecticut’s health insurance exchange could leave the market this fall, the leader of the exchange warned Wednesday.
“This is a threat knocking on our doors for the next open enrollment,” Access Health CT CEO Jim Wadleigh told the agency’s board of directors. “Come the first week in September, there is a chance that the two insurance companies participating and offering plans through Access Health CT will leave the individual market on-exchange.”
Wadleigh said insurers feel threatened by the Trump administration’s refusal to commit long-term to making billions in key payments to companies that sell plans on Obamacare exchanges. The cost-sharing reduction payments offset the expense to insurers to sell plans with reduced deductibles and copays to low-income customers.
This is a threat knocking on our doors for the next open enrollment.
ConnectiCare and Anthem — the two insurers who sell on Connecticut’s Affordable Care Act exchange — requested average rate increases of 17.5 percent and 33.8 percent for next year, but those increases didn’t take into account the end of the cost-sharing reduction payments. Rates could jump another 20 percent if the cost-sharing reduction payments are ended, officials said, with exchange customers who don’t qualify for subsidies bearing the brunt of the increase.
“Many insurers might react to the end of subsidy payments by exiting the ACA marketplaces,” the Kaiser Family Foundation wrote in a report earlier this year. “If insurers choose to remain in the marketplaces, they would need to raise premiums to offset the loss of the payments.”
Of the roughly 98,000 people buying plans on Access Health CT, about half qualify for cost sharing reduction payments, Wadleigh said.
House Republicans under President Barack Obama sued to prevent the payments from being made. That case is still winding its way through federal courts. An appeals court ruled this week that state attorneys general, including Connecticut Attorney General George Jepsen, could intervene in the suit because ending the payments “would lead directly and imminently [lead] to an increase in insurance prices, which in turn will increase the number of uninsured individuals for whom the states will have to provide health care.”
Rates could jump another 20 percent if the cost-sharing reduction payments are ended.
“The conversation comes down to what goes on in Washington,” Wadleigh told reporters after the board meeting. “And right now, on a daily basis, we see a number of tweets that are coming out of Washington that talk about the potential of not making those cost-sharing reduction payments. That adds risk to an industry that is solely based on avoiding risk.”
Wadleigh was referring to President Donald Trump, who over the weekend tweeted: “If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!”
The state Insurance Department is supposed to approve rates for next year on Sept. 1, but that may be pushed back to the end of the month. Insurance Commissioner Katharine Wade said she “hoped” the cost-sharing reduction payment issue would be resolved before the end of the month.
“I’m troubled by hope playing such a central role in this process,” said Robert F. Tessier, vice-chair of the Access Health CT board. “It leaves me with an uncomfortable feeling.”
Wadleigh reiterated that customers who currently buy Access Health CT plans will be covered for the remainder of the year and said the exchange is planning for all scenarios, including if both insurers depart.
I guess it’s better late than never but the problem is we’re up against the clock.
After the failure by Senate Republicans to pass a health care bill, the Senate’s health committee has scheduled bipartisan hearings for the first week of September on how best to shore up the existing Obamacare markets.
“I guess it’s better late than never but the problem is we’re up against the clock,” Sen. Chris Murphy, a member of the committee, said on MSNBC this week. “Insurers are making decisions this fall about the rates that they will offer on the exchanges.”
Wadleigh said he hoped the Senate would act and “bring some stability” to the market.
If both insurers leave, Wadleigh has said Access Health CT would take on the task of transitioning its customers to off-exchange plans in the individual market.
Date:Aug 03, 2017