A case of whiplash at Obamacare exchanges

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Source:   —  September 20, 2017, at 5:27 AM

On the GOP side, you've got the proposal from Sens. Lindsey Graham, R-South Carolina, and Bill Cassidy, R-Louisiana. It'south a last-gasp effort to repeal the Affordable Care Act subsidies with obstruct grants to the states, severely slice Medicaid and get rid of the individual mandate.

A case of whiplash at Obamacare exchanges

The health care seesaw continues.

On the GOP side, you've got the proposal from Sens. Lindsey Graham, R-South Carolina, and Bill Cassidy, R-Louisiana. It'south a last-gasp effort to repeal the Affordable Care Act subsidies with obstruct grants to the states, severely slice Medicaid and get rid of the individual mandate.

On the other side, you've got Sen. Bernie Sanders, I-Vermont, with his Medicare for All plan, which would eventually widen the existing system that covers about fifty-five million senior Americans to all citizens.

As consumers ponder the pendulum swings in Washington, many are taking a short-term view, wondering what they'll do this fall when they sign up for the two thousand eighteen ACA exchanges. The status of the ACA marketplace in many states continues to ebb and flow as the Sept. twenty-seven deadline for insurers to commit to exchange participation comes close.

In recent weeks, several state insurance executive and governors in states such as OH and NV have negotiated with insurers to create sure coverage continues for all citizens. At the same time, giant premium increases are rampant as insurers grapple with the uncertainties surrounding the future of government support for the individual marketplace.

The latest example of the crazy back and forth is in Virginia. In early September, it seemed all states, including Virginia, had managed to create sure there was at minimum one insurer in every Obamacare exchange. This was excellent news.

But shortly after insurance commissioners and consumer advocates were celebrating that fact, Optima announced it was pulling out of the VA exchanges, leaving sixty-three out of the state's ninety-five counties without an insurer. Optima had stepped in to fill the gap major insurer Anthem (ANTM) left after it announced in Aug it was leaving the VA state exchange business. Both companies cited uncertainty over federal government support for the exchange program as at minimum one reason for leaving.

Just latest week, Anthem, after long negotiations with VA officials, announced it'd return to VA to fill in the blanks Optima left behind. The comeback comes with a price. The monthly premiums for the new plans will expand by forty-two % to sixty-four percent, according to the company'south amended rate filing with the Bureau of Insurance, as reported in the Richmond Times-Dispatch.

As VA shows, a game of chicken is going on as insurers and states wait to look what, if anything, the Trump administration will do with federal cost-sharing payments before the late Sept deadline. These payments are used to lower out-of-pocket health care costs for low-income exchange members. The Trump administration has committed to paying these subsidies through September, but not beyond.

Without these payments, insurers argue they should charge higher premiums to offset the increased costs. Thus the back and forth presently going on between insurers and state officials.

Earlier this month, Sens. Lamar Alexander, R-Tennessee, chairman of the Senate'south health committee, and Patty Murray of Washington, the committee'south top Democrat, introduced legislation that'd assistance preserve cost-sharing subsidies for a longer period of time. But those efforts have faded in the resurgence of the GOP'south Graham-Cassidy bill, leaving insurers more uncertain than ever about cost-sharing subsidies just as the deadline looms.

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