Insurers have a few months to decide whether to participate in Obamacare’s exchanges after an effort to stabilize them fell apart Thursday.
The deadline to submit health plans and preliminary costs for the law’s exchanges is June 20, and insurers will have to make the decision on participation knowing that a bill to give them funding to help lower premiums won’t be coming anytime soon.
Experts predict that premiums on the exchanges will be higher next year, when the government stops fining people for not having insurance. Open enrollment starts Nov. 1.
Insurers expressed disappointment that infighting over abortion language defeated the stabilization package, which lawmakers tried to add to the government spending bill last week.
“Premium reduction measures in the individual market would have ensured that Americans who buy their own coverage had more affordable choices that offer access to high-quality care,” said America’s Health Insurance Plans, the leading insurer lobby group. “We are disappointed that Congress was unable to take this opportunity to help reduce premiums for hardworking Americans.”
The Blue Cross Blue Shield Association, which includes Blue Cross insurers across the country, said Congress must try again.
“Unless Congress acts now, premiums will again increase significantly and consumers could have even fewer health plan choices. Already, half the counties in the U.S. have only one insurer,” said Justine Handelman, senior vice president for the association’s office of policy and representation. “Congress must find a path forward to provide consumers with the peace of mind they deserve. Millions of Americans are depending on lawmakers to act.”
The individual market has been hemorrhaging insurers for the past few years partly because of volatility in the law’s risk pools and President Trump’s decision to halt insurer payments last fall. The bill would have restored funding for those payments.
Experts say premiums are already high for people on the law’s exchanges. People who do not have health insurance through the government or their employer can buy insurance on the individual market, which includes Obamacare’s exchanges.
“Though it’s not looking like Congress is going to do anything about it this year, premiums are still high for middle-class consumers in the individual market,” tweeted Larry Levitt, senior vice president at the research firm Kaiser Family Foundation. “And, it’s going to get worse in 2019 once repeal of the individual mandate penalty takes effect.”
The Congressional Budget Office found the Obamacare bill would have lowered premiums on the individual market by 10 percent next year and 20 percent in later years.
Another study by firm Oliver Wyman found that the bill would lower premiums by up to 40 percent by 2021.
The bill would fund Obamacare insurer payments called cost-sharing reduction payments for three years. The payments reimburse insurers for a requirement to lower out-of-pocket costs for low-income Obamacare insurers.
It also would give states $30 billion over three years to set up a reinsurance program, which covers the highest claims. The idea is to give insurers an incentive to lower premiums overall.
But the legislation was not included in the spending bill because of a disagreement over abortion funding.
Lawmakers supporting the legislation said that they would try again to get the bill through Congress, but acknowledge time is running out.
House Energy and Commerce Committee Chairman Rep. Greg Walden, R-Ore., said Thursday before the failed bid that sponsors of legislation would likely get together and “see a path forward and talk to leadership about it. These people [are] stuck on the exchanges.”
Walden didn’t say when the bill could get through Congress, only noting that “time is running out.”
The omnibus is likely to be the last must-pass vehicle until federal funding runs out at the end of the federal fiscal year on Sept. 30. Supporters of the legislation have long said that it would need a must-pass vehicle to be added onto as House Republicans view stabilization with major skepticism.
