ACA Exchanges Expanding, Future Still Uncertain
Some insurance companies are stepping in to fill the void of health plans in multiple counties with bare health insurance exchanges across the country. While this bodes well for the stability of exchanges in the short-term, the long-term stability of the individual and small group market is uncertain under the Trump Administration’s repeated threats to discontinue important cost-sharing reduction (CSR) payments. Meanwhile, some members of Congress are trying to ensure that these subsidies continue regardless of the President’s actions.
With President Trump’s looming threats to cut the CSR payments and the potential changes to Affordable Care Act being considering in Congress, insurers had been steadily pulling out of exchange markets. Bucking this trend, some insurers have recently decided to extend individual coverage options to bare counties in states like Ohio and Indiana for 2018, leaving only one county in each of those states without an insurance option on the marketplace exchange, and making the market stronger in the short-term than previously anticipated.
The CSR subsidies lower out-of-pocket costs for low-income individuals who purchase insurance through an exchange, accounting for roughly 7 million people this year. If the Trump Administration terminates the payments, insurers would be forced to either stop selling coverage or increase their rates as much as 20 percent, according to analysis by the Kaiser Family Foundation.
Last month, Representative Kevin Brady (R-TX), Chairman of the House Ways and Means Committee, specifically called on Congress to provide funds to stabilize the individual insurance market. Additionally, a coalition of about 40 House members on both sides of the aisle have been discussing a marketplace stabilization bill, hoping to prop up struggling exchanges, particularly those in rural areas.