US Hundreds of counties at risk for no Obamacare insurer in 2018
Obamacare’s Future Now Depends on an Unhappy White House
President Trump has said he’d like Obamacare to fail, and the Department of Health and Human Services has advertised its failures.The congressional effort to overhaul the health care system appears to be in shambles. But the current health care system lives on. And decisions the Trump administration makes about how to manage it could have big effects on who has coverage next year, and what it costs them.
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The Republican war on the CBO, explained
The Trump administration is not fond of the Congressional Budget Office. The Trump administration is not fond of the Congressional Budget Office.
With Republican efforts to dismantle Obamacare in disarray, hundreds of U.S. counties are at risk of losing access to private health coverage in 2018 as insurers consider pulling out of those markets in the coming months.
Republican senators failed this week to repeal and replace Obamacare, former President Barack Obama's signature healthcare reform law, creating new uncertainty over how the program providing health benefits to 20 million Americans will be funded and managed in 2018.
In response, Republican President Donald Trump on Friday again suggested that his administration would let the Obamacare program “implode.” He has weakened enforcement of the law’s requirement for individuals to buy insurance, threatened to cut off funding and sought to change plan benefits through regulations.
If Republicans don't repeal ObamaCare, they'll feel sick next election
OPINION | The GOP is playing a dangerous game in delaying repeal of ObamaCare.Editor’s note: The opinions in this article are the author’s, as published by our content partner, and do not necessarily represent the views of MSN or Microsoft.
Anthem Inc, Cigna Corp, Health Care Service Corp and Molina Healthcare, four of the biggest health insurers selling Obamacare plans, said they are weighing whether to pull out of more markets for 2018 rather than face financial losses. They have until Sept. 27 to finalize their plans.
So far, 40 U.S. counties are expected to have no insurer offering individual coverage next year, but that number could rise by the hundreds, according to U.S. government data, Kaiser Family Foundation analysis and insurer disclosures. More than 1,300 counties, primarily in 15 states, currently have only one insurer participating in 2018. Anthem and HCSC are the last man standing in one-third of those counties and states - putting those areas in particular at risk.
GOP reverses course on healthcare
Senate Republican leaders are desperately searching for the 50 votes they need to open a debate on ObamaCare repeal-and-replace legislation after a Wednesday scolding at the White House from President Trump. Leaders have reopened negotiations on their previous bill, reversing course from their plans to move to a vote on a straight repeal of ObamaCare.But it's not clear if they will have any more luck this time in corralling enough centrist and conservative Republicans to move the bill forward.Senate Majority Leader Mitch McConnell (R-Ky.
“Right now the number of counties at immediate risk of having no insurers in 2018 is small, but it could easily grow significantly if a couple major insurers decide to exit,” Larry Levitt, health economist at the Kaiser Family Foundation, said.
Many insurers have been waiting for an answer from Trump or lawmakers on whether they will continue to fund $8 billion in annual government subsidies. Without assurances, many insurers plan to raise rates an additional 20 percent by an Aug. 16 deadline for premium prices. Others say that the many unknowns will make the business too risky.
The last-minute drama has left millions of Americans questioning whether they will have medical coverage next year.
Julie Grady, a 59-year-old small business owner in Carson City, Nevada, is currently covered by Blue Cross Blue Shield of Nevada, part of Anthem, which has already decided to leave the exchanges in her county and most of the state. Carson City will have no insurer on the exchanges next year.
Grady’s pays a reduced premium of $70 per month and a deductible under $1,000 for her plan, which is part of the Affordable Care Act, commonly called Obamacare. Grady is looking at being uninsured, as she was before the law.
Trump’s final health care pitch makes promises he can’t keep
As he attempts to close what has been an elusive deal among Republicans on a Senate bill to repeal and replace Obamacare, President Donald Trump continues to make bold promises about what that bill would do — promises that all available analysis suggests the bill will not keep. Trump made a final-appeal speech on Monday, which was light on policy and heavy on pressuring Republican senators to vote for the bill when it’s expected to come to the floor for a procedural vote on Tuesday. It included one section in which the president gave a small list of how health care would change should the Better Care Reconciliation Act become law. Trump promised the new health care bill would “significantly lower premiums” and “stabilize the insurance market.” He shared horror stories of families who had relied on the Affordable Care Act for coverage but ultimately liquidated a 401(k) retirement account in order to cover their large deductibles. The truth, however, is that the Senate bill will not lower premiums for many people. For low-income Americans, in particular, premiums could rise by as much as 700 percent. Nonpartisan analysis from the Congressional Budget Office estimates that the Senate bill would destabilize the individual market. And those plans with large deductibles? They would become more common should the Senate bill become law.
“I would have to go without health insurance,” she said. “I would just stay healthy, hike, eat well. I’d be in trouble if something catastrophic happened. I would lose everything.”
ANTHEM CONSIDERING 2018 PLANS
Anthem, the second-largest U.S. health insurer, sells Blue Cross Blue Shield plans in 14 states. It has already decided to pull out of most individual markets in Nevada, Ohio, Indiana and Wisconsin in 2018. Earlier this week, Chief Executive Officer Joe Swedish said he was still weighing 2018 participation in its other states.
In states like Colorado, Georgia, Kentucky, Missouri, and Virginia, Anthem sells plans in more than 250 counties where it is the only insurer, and they could be left "bare" next year, according to government data.
Health Care Services Corp is a Blue Cross Blue Shield licensee in five states and is the only Obamacare individual insurer in more than 90 Texas counties, more than 75 Oklahoma counties, and half a dozen Illinois counties. It confirmed on Friday that it has submitted products for its five states but is still weighing next year.
"We’re working through the regulatory filing process and hope to fully participate...in 2018, however no final decisions have been made," HCSC spokeswoman Kristen Cunningham said.
Consensus Is Health Law Can Be Fixed. Now the Hard Part.
Stabilizing the market, lowering drug prices and expanding access to coverage would go a long way to easing millions of Americans’ concerns.The seven-year-old law has survived Supreme Court decisions and aggressive attempts to extinguish it by Republicans in Congress and the White House. But even people who rely on its coverage agree that it still has big problems. The question for the roughly 20 million Americans who buy their own health coverage — and for millions of others who remain uninsured — is what can realistically be done to address their main concerns: high prices and lack of choice in many parts of the country.
Molina, which has more than 1 million members in Obamacare plans, and Cigna, with more than 250,000 participants, have said they need more certainty from the government to decide on 2018 participation and would weigh their decisions up until the late September deadline.
State insurance regulators have worked hard in recent months to replace insurers who have left. In Nevada, for instance, Centene Corp and Aetna Inc entered in some counties that Anthem left after the insurance commissioner said he would favor these insurers for its Medicaid contract bids.
But they are unlikely to find replacements for new dropouts in these final weeks, particularly if the Trump administration signals it won’t fund $8 billion in subsidies for out-of-pocket medical costs.
"There is almost no chance they would step in to participate," said Kurt Wrobel, a fellow at the Society of Actuaries and chief financial officer of the Geisinger Health Plan in Pennsylvania.
Some insurers say they will likely just raise rates and hope it works. Blue Cross Blue Shield of Michigan filed two sets of rates with the state department of insurance, one up to 32 percent higher if the fate of subsidies remains unclear.
"We don't have any plans to pull out,” said Rick Notter, director of the individual business at BCBS Michigan. “But it would certainly help to have more certainty around what the market holds."
(Additional reporting by Jilian Mincer; Editing by Michele Gershberg and Cynthia Osterman)
House Moderates Have a Bipartisan Health-Care Bill .
But will the GOP leadership allow moderates to make Obamacare work better, when conservative donors want to see it fail?And then, there are the few GOP lawmakers who are interested in lowering premiums for their constituents by passing small-bore, technocratic fixes to Obamacare (as opposed to trying to do so by sacrificing cancer patients’ regulatory protections on the altar of the almighty invisible hand).
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