Governors urge Administration to stabilize health insurance marketplaces

The National Governors Association (NGA) Health and Human Services Committee has appealed for government action to stabilize individual health insurance marketplaces for the coming year. Committing to fully funding cost-sharing reductions (CSRs) for the coming year would provide much needed short-term stability in the current health insurance marketplaces, it suggested. 

statement released by the committee, led by Virginia Governor Terry McAuliffe and Massachusetts Governor Charlie Baker, highlighted the "uncertainty" around CSR payments, observing this has pushed up premiums for consumers in many parts of the country and led some insurers to exit the marketplace altogether. 

Under the Affordable Care Act (ACA), also known as Obamacare, insurers are required to offer low-deductible health plans to people on a low-income. More than half (58%) of those enrolled in marketplace plans were subsidized by CSRs in 2017, which equates to 5.9 million people across the country, according to figures collated by the Kaiser Family Foundation (KFF). The ACA requires the federal government to reimburse insurers with a cost-sharing subsidy payment to offset the cost to insurers.

Following U.S. Senate's rejection of the GOP bill to repeal the ACA on July 28th, 2017, President Donald Trump tweeted: "If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon." Signals from the Administration indicating payments may be stopped increases uncertainty in the marketplace and has already driven up premiums for consumers, the NGA claimed. 

"A first critical step in stabilizing the individual health insurance marketplaces is to fully fund CSRs for the remainder of the calendar year 2017 through 2018. This is a necessary step to stabilize the individual marketplaces in the short term as Congress and the Administration address long-term reform efforts." 

Reassuring insurers and states that funding for CSRs will continue is "critically important", the NGA asserted, calling for immediate action from the Administration to improve marketplace stability, prevent further loss of insurers from the market, and protect consumers from rising premiums.

In the coming year, one-third of counties in the U.S., mainly those in rural areas, have only one insurer available, according to data collated by KFF. Furthermore, the report highlighted 38 counties in Nevada, Ohio, and Indiana in danger of having no insurers on the exchange, potentially leaving around 25,000 people without cover in 2018.

Sign up for health insurance for the year starting January 1st, 2018 begins on November 1st, 2017 and runs until December 15th. In previous years, the window remained open until January 31st, which could precipitate a rush to sign up for health insurance on HealthCare.gov in December.  Contributing to the NGA's call for immediate action is that fact that this month insurers will finalize rates for the coming year and make decisions about whether or not to participate in the individual marketplaces.