nsurance startup Oscar Insurance Corp. said it plans to expand its offerings in the Affordable Care Act marketplaces, as insurers face a federal deadline Wednesday for initial filings to participate in the health law’s exchanges next year.
Oscar, which has been under a spotlight partly because of its tie to the Trump administration, said it aims to begin selling ACA plans in Tennessee for the first time in 2018, and re-enter the exchange in New Jersey, where it sat out this year. The insurer also will expand the regions where it sells ACA plans in California and Texas, and will continue selling plans in its home market of New York. Last week, Oscar announced that it will begin selling marketplace plans in Ohio next year, working with the Cleveland Clinic.
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The struggles faced by Presidents Obama and Trump since the passage of the Affordable Care Act have created the impression that it’s impossible to successfully reform American health care. On the non-group market, premiums have soared, networks have narrowed, individuals have refused to enroll, and insurers have fled the marketplace. But despite the dysfunction of the market that was the primary focus of the ACA’s reforms, employer-provided coverage and the Medicare program have never been in better shape. Under those arrangements, which cover the majority of Americans, spending growth has abated, quality of care is improving, and premiums are rising at the slowest rate in recent memory. President Obama tried to claim credit for these trends, but they actually date to 2003, when President Bush pushed his own signature legislative achievement, the Medicare Modernization Act, through Congress.
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The Trump administration has made critical ObamaCare payments to insurers for the month of June but won’t provide any certainty about whether they’ll continue in the future.
The payments, known as cost sharing reduction subsidies, reimburse insurers for providing discounts to low-income patients.
Insurers have been threatening to raise premiums — or leave the ObamaCare markets — if they don’t receive certainty about the payments from Congress or the White House.
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The health care industry killed Hillarycare in the 1990s and cut deals to shape Obamacare more to its liking in 2009. But now, as Republicans push a sweeping and widely reviled health bill through Congress, the industry has often appeared declawed in the biggest health care fight of the decade.
It’s a deliberate strategy, interviews with nearly 20 lobbyists and other experts suggest. Health industry groups generally don’t love Obamacare enough to jeopardize their ability to shape the rest of the Republican agenda — including big corporate tax cuts. They also fear incurring White House retaliation.
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