The nation’s health insurers, resigned to the idea that Republicans will repeal the Affordable Care Act, on Tuesday publicly outlined for the first time what the industry wants to stay in the state marketplaces, which have provided millions of Americans with insurance under the law.So basically, they want the subsidies, marketplaces, and mandates, but apart from that they are fine with whatever is done.
The insurers, some which have already started leaving the marketplaces because they are losing money, say they need a clear commitment from the Trump administration and congressional leaders that the government will continue offsetting some costs for low-income people. They also want to keep in place rules that encourage young and healthy people to sign up, which the insurers say are crucial to a stable market for individual buyers.
On Tuesday, Marilyn Tavenner, the chief executive of America’s Health Insurance Plans, a leading industry trade group, warned that the state marketplaces were already on unstable financial footing. Failing to continue the funding aimed at low-income Americans, she said, would have far-reaching consequences because the business would become much tougher for insurers.
Hospital groups also held a news conference on Tuesday to warn of what they said would be the dire financial consequences of a repeal if the cuts to hospital funding that were part of the Affordable Care Act were not also restored.
Ms. Tavenner did not give many details about her group’s positions, but she said its top priority was to stop the immediate threat of eliminating the subsidies for plans sold to low-income people. House Republicans have already sued to block these payments, and the lawsuit is now delayed. If the new administration chose not to defend the lawsuit, the money would disappear, and insurers would probably rush to the exits because fewer potential customers would be available.
Another of the industry’s concerns is ensuring that enough young and healthy people sign up to stabilize the market. Republicans have discussed eliminating one of the law’s main tools, the so-called individual mandate, a tax levied on those who do not enroll.
In talking with Congress, Ms. Tavenner said, her members are emphasizing the need for some alternative, especially after criticism by insurers that the penalty is not large enough to persuade enough people to enroll. “There’s not one magic solution,” she said. She pointed to some of the provisions in Medicare that encourage people to sign up before they become sick. And she discussed some options to ease how insurers price their policies to be able to offer plans that are less expensive to younger people.
She also argued that the insurers had no desire to return to the time before the law was passed, when people with pre-existing conditions were routinely denied coverage in the individual market.
Of course, subsidies, marketplaces, and mandates are Obamacare: The rest is commentary.*
*Yes, I am applying a quote from Rabbi Hillel.