Senate Republicans have returned from a seven-week recess with a unified message they plan to repeat until November: Obamacare is imploding.
News of double-digit premium increases in 2017, insurers pulling out of the marketplace, failing co-ops, and low enrollment numbers have handed an opportunity to Senate Republicans who worried about losing the majority in the fall. They get to say, “I told you so,” after a six years of Obamacare messaging, and they get to tell voters that a GOP majority will fix these issues.
. . .
Six Republican Senators introduced a bill that would exempt consumers living in counties where zero or one insurer is offering plans on the federal exchanges from the Affordable Care Act’s individual mandate.
The legislation comes after several recent analyses have shown the number of U.S. counties with one insurer offering plans on the Affordable Care Act exchange is expected to increase next year. Pinal County in Arizona currently has no insurers planning to offer plans on the marketplace. Under the 2010 health care law, people who are able to afford health insurance are required to purchase insurance or pay a fine to the federal government.
. . .
The Centers for Medicare and Medicaid Services on Monday issued a proposed rule to govern how Obamacare exchanges will operate in 2018. The proposal would change Obamacare’s risk adjustment program to account for prescription drug data.
Currently, the government determines which plans have sicker enrollees, and thus should receive assistance, based on claims data.
. . .
The insurance marketplaces created under the Affordable Care Act face some similar challenges that public insurance programs have faced as they’ve gotten off the ground.
Steps that were taken to stabilize Medicare Advantage and Medicare Part D could be a starting point to stabilize the ACA insurance exchanges, a policy brief released Tuesday by the Robert Wood Johnson Foundation suggests.
The report comes a day after Aetna announced it would not offer policies in most exchange markets in 2017 where it has offered plans this year, becoming the latest major insurer to do so. Scrutiny has increased around the exchanges since major insurers including UnitedHealth and Humana have announced they would pull back from from the exchanges for 2017.
. . .
Aetna, one of the nation’s largest health insurers, announced Monday it is pulling out of all but four state exchanges in 2017. It is currently offering exchange plans in 15 states.
Aetna is only the latest insurer to reduce its marketplace presence, citing losses. The news also comes amid reports of double-digit premium hikes next year, another sign of financial trouble for insurers. Most of the nonprofit co-op plans created under the health care law have also shuttered.
“Following a thorough business review and in light of a second-quarter pretax loss of $200 million and total pretax losses of more than $430 million since January 2014 in our individual products, we have decided to reduce our individual public exchange presence in 2017, which will limit our financial exposure moving forward,” said Aetna chairman and CEO Mark Bertolini in a statement.
. . .
Projected employer benefit costs are a stark contrast to the expected premium increases and out-of-pocket costs on the Obamacare exchanges next year. Employer-sponsored premium increases are expected to be about half of what has been proposed on individual exchanges for next year. Net deductibles are expected to be, on average, about one-third of those on exchange plans.
The difference could be explained in part by the relative age of the different marketplaces. While insurers are still adjusting to the relatively new Obamacare exchanges, the employer-based marketplace has many more years of experience to help keep costs stable. The employer market also likely has a better mix of sick and healthy people, helping keep costs down, on average.
. . .
At issue in House v. Burwell is whether the administration has been illegally paying cost-sharing reduction subsidies to insurers. This issue was also the subject of a Republican House investigation, which resulted in a recent report concluding that the administration knowingly made the payments without a congressional appropriation, which is illegal.
In May, district court judge Rosemary Collyer sided with the House, deeming the payments illegal. The administration is appealing. If it is unsuccessful, it will be a serious blow to already struggling Obamacare exchanges.
. . .
Humana will exit eight of the 19 individual health insurance markets where it has sold Obamacare plans this year, the insurer announced Thursday.
The company is still struggling to make a profit on the exchanges, according to its second quarter earnings guidance released Thursday. The company expects to offer individual plans in 156 counties across 11 states compared to the 1,351 counties in 19 states it has offered plans in the year, according to a release.
. . .
The Republican party’s 2016 platform, unveiled Monday, echoes many of the proposals included in the health care plan House Republicans laid out last month.
The platform calls for the full repeal of the Affordable Care Act and for state control of insurance markets. It backs selling insurance across state lines and states that insurance should be more portable so that consumers can move from job to job with the same policy.
“We must recover the traditional patient-physician relationship based on mutual trust, informed consent, and confidentiality,” the platform reads.
. . .
The Republican leading the House caucus’ campaign arm said the party’s presumptive nominee will work with the caucus to replace the Affordable Care Act if elected in November.
“House Republicans have put forward patient-centered health care that will be affordable for families,” Rep. Greg Walden (R-Ore.) said Monday in a speech at the Republican National Convention. “We’re offering a real alternative, and showing voters that Republicans are the party of new and good ideas, while Democrats are clearly the party of the failed status quo, especially on health care.”
. . .