A bipartisan group of governors is trying to jump-start efforts to strengthen private insurance under the Affordable Care Act, urging Congress to take prompt steps to stabilize marketplaces created by law while giving states more freedom from its rules.

In a blueprint issued Thursday, the eight governors ask House and Senate leaders of both parties to take several steps to reverse the rising rates and dwindling choices facing many of the 10 million Americans who buy health plans on their own through ACA marketplaces.

Specifically, the state leaders say Congress should devote money for at least two years toward “cost-sharing subsidies” that the 2010 health-care law promises to pay ACA insurers to offset deductibles and other out-of-pocket expenses for lower-income customers.

. . .

A group of 11 states and the District of Columbia running their own Obamacare exchanges want more federal funding to stabilize exchanges facing higher premiums and insurer defections.

The states wrote to leaders of the Senate Health, Education, Labor and Pensions Committee with their ideas on Tuesday. Those include guaranteeing insurer payments and establishing a permanent reinsurance fund to help insurers.

. . .

Residents in every U.S. county are expected to have at least one insurer to buy coverage from on Obamacare’s exchange when open enrollment starts in November, but several difficult decisions lie ahead for customers, particularly those who will not receive any help paying for their premiums.

Those customers are facing significantly higher costs for their policies, and those whose current insurer isn’t providing coverage for 2018, whether subsidized or not, likely will have to change doctors and hospitals to make sure they aren’t slammed with high out-of-pocket medical expenses.

. . .

Iowa on Tuesday submitted to the federal government a final request to make changes to try to shore up its struggling ObamaCare insurance marketplace.

The plan from the Iowa Insurance Division is intended to be a short-term market stabilization solution to entice more insurers into the marketplace. The state is facing what it calls a “collapse” of its ObamaCare marketplace after all but one insurer declined to offer plans for 2018.

. . .

In Iowa, the state’s sole remaining insurer announced on Thursday that it wants to boost ObamaCare premiums by 57%. This isn’t exactly the vibrant, competitive, low-cost market that Democrats promised. But it is the inevitable outcome of ObamaCare’s government-knows-best approach to health care.

Earlier this year, Aetna and Wellmark Blue Cross & Blue Shield announced that they were pulling out of Iowa’s ObamaCare exchange, leaving only Medica, which was also threatening to leave. Not surprisingly, Medica has used its newfound monopoly status to push for increasingly higher rates, while trying to pin the blame President Trump for the increases.
. . .

The mere existence of ACA insurance policies can’t be the only metric for measuring the success of a major federal program. Another sensible measure of ACA success is the affordability of the policies being sold. For a broad spectrum of middle-aged persons in the middle class, premiums for even the cheapest bronze policy today are, in a majority of rating areas examined, so expensive that people are formally exempt from the individual mandate.

. . .

The government will make this month’s payments to insurers under the Obama-era health care law that President Donald Trump still wants to repeal and replace, a White House official said Wednesday.

Trump has repeatedly threatened to end the payments, which help reduce health insurance copays and deductibles for people with modest incomes, but remain under a legal cloud.

A White House spokesman said “the August payment will be made,” insisting on anonymity to discuss the decision ahead of the official announcement. The so-called “cost-sharing” subsidies total about $7 billion this year and are considered vital to guarantee stability for consumers who buy their own individual health insurance policies.

. . .

The Affordable Care Act (ACA) requires insurers to offer plans with reduced deductibles, copayments, and other means of cost sharing to some of the people who purchase plans through the marketplaces established by that legislation. The size of those reductions depends on those people’s income. In turn, insurers receive federal payments arranged by the Secretary of Health and Human Services to cover the costs they incur because of that requirement. At the request of the House Democratic Leader and the House Democratic Whip, the Congressional Budget Office and the staff of the Joint Committee on Taxation (JCT) have estimated the effects of terminating those payments for cost-sharing reductions (CSRs). In particular, the agencies analyzed what would happen under this policy: By the end of this month, it is known that CSR payments will continue through December 2017 but not thereafter.
. . .

A majority of cities—71 percent—will see Obamacare premiums rise by double-digits next year as more health insurers drop out of the exchanges, according to a report from the Kaiser Family Foundation.

The foundation analyzed data in the 20 states and in Washington, D.C. that had submitted rate filings to examine how much premiums were rising and how many insurers were participating on the exchanges.

. . .

The Trump administration is giving health insurance companies more time to calculate price increases for 2018 because of uncertainty caused by the president’s threat to cut off crucial subsidies paid to insurers on behalf of millions of low-income people.

Federal health officials said the deadline for insurers to file their rate requests would be extended by nearly three weeks, to Sept. 5.

. . .