Although insurers have generally remained profitable overall since implementation of the Affordable Care Act, many companies participating in the individual market – where most of the major market reforms took place in 2014 – experienced substantial losses in this market in the early years of reform. The individual market is where just 7% of the U.S. population gets their insurance (and thus also represents a small share of most health insurers’ business), but the stability of the market and willingness of insurers to continue to participate is essential to the ACA’s success. Going into 2017, there were a number of high-profile exits and premium increases, raising concerns over the stability of the individual market. Although some local markets are likely fragile, the Congressional Budget Office expects the ACA individual market to remain stable across most part of the country.

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Insurance executives, as well as the head of the trade group America’s Health Insurance Plans, met with Seema Verma, administrator of the Centers for Medicare and Medicaid Services, on Tuesday. Insurers have been pressuring administration officials and lawmakers to fund the ACA’s cost-sharing reduction payments. Insurers have struggled to adjust to the individual marketplaces since the ACA created the exchanges, and the ACA’s uncertain political future has only added to the questions they face as they approach the June 21 deadline for filing their 2018 premium rate requests. That will be the first indication of how the individual exchanges fare next year.

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With time running out to set insurance prices and uncertainty surrounding whether the Trump administration will continue funding cost-sharing subsidies on the ACA exchanges, several states are giving health insurers a little more wiggle room to file 2018 rates. State insurance regulators hope an extra few weeks to price plans will be enough to ease the insurance industry’s jitters created by efforts to repeal and replace the ACA and keep insurers from bailing on the exchanges. Colorado, New Hampshire, Oregon and Kentucky have extended deadlines for insurers to submit rates for 2018 ACA health plans.

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Judicial Watch today released 944 pages of Department of Health and Human Services (HHS) records showing that the Obamacare website was launched despite serious concerns by its security testing contractor, Mitre Corporation, as well as internal executive-level apprehension about security.

The documents reveal that Mitre recommended a “Denial Authorization to Operate” in the month prior to Obamacare’s launch, noting that it could not adequately test the confidentiality and integrity of the system. It said that complete end-to-end testing of the system never occurred. Miter found that 11 “moderate” security findings and eight “low” findings remained open as September 19, 2013 – 12 days before the launch.

And an unsigned “Authorization to Operate” prepared just five days before Obamacare’s launch, indicates that the site’s “validation contractor” was “unable to adequately test the confidentiality and integrity of the [Federally Facilitated Marketplace] system in full.” That contractor, Blue Canopy, noted that they were able to access data “that should not be publically accessible.”

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The Trump administration says it is willing to continue paying subsidies to health insurance companies under the Affordable Care Act even though House Republicans say the payments are illegal because Congress never authorized them. The statement sends a small but potentially significant signal to insurers, encouraging them to stay in the market. The future of the payments has been in doubt because of a lawsuit filed in 2014 by House Republicans, who said the Obama administration was paying the subsidies illegally.

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A second major health-insurer has decided to quit selling individual policies in Iowa, raising fears that tens of thousands of Iowans will have no options for coverage next year.

Aetna informed Iowa regulators Thursday that it had decided to stop selling such policies, which cover people who lack access to employer-provided coverage or government plans. The move would affect 36,205 customers, the company told regulators.

Aetna’s move takes effect in January. It came three days after Iowa’s dominant health-insurer, Wellmark Blue Cross & Blue Shield, announced that it would no longer sell individual health-insurance policies in Iowa.

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More insurance companies around the country are refusing to pay brokers commissions on higher-tier exchange plans or special enrollment sales as the companies face financial losses on the federal marketplace. “It’s the Wild West out here, and companies are doing what they can to survive,” says Ronnell Nolan, CEO of Health Agents for America, which represents independent insurance brokers. “They’re not paying commissions on platinum plans, and they are not paying them for special enrollment plans which cover some of the sickest patients.” An exodus of brokers from the federal marketplace could undermine enrollment efforts since brokers historically sign up at least 50% of exchange enrollees.

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The Trump administration indicated that it plans to continue the Affordable Care Act’s cost-sharing subsidies while they are part of ongoing litigation, one administration official said Monday, in what may be the clearest statement on the issue so far.

The precedent that the cost-sharing subdues would be funded while the lawsuit is being litigated remains the policy of the current administration, according to the official, who spoke on conditions of anonymity.

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On June 21, 2017, health insurers have to decide whether they will sell coverage on the Obamacare marketplaces. “It will give us the first indication of what the ballpark rate increases are, what counties have insurers and which ones don’t,” says Robert Laszewski, an industry consultant who works with insurers that sell on the marketplace. “Insurers will have to make a statement.” The number of insurers selling on the marketplace fell significantly this year. There are 960 counties on Healthcare.gov that had just one health insurer selling coverage in 2017. That was a big increase from the 180 counties in the same situation in 2016.

Another insurer sued the U.S. government to recoup unpaid payments under the ACA’s risk-corridor program, but it’s looking less and less likely that the feds will ever pay up.

Sanford Health Plan, the insurance arm of Sioux Falls, S.D.-based Sanford Health, sued the federal government, demanding it pay nearly $9 million in overdue risk-corridor payments for 2014 and 2015. The CMS so far has paid Sanford Health Plan just 15.1% of the amount it owes, according to the complaint filed last week in the U.S. Court of Federal Claims.

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