Health insurers want to see how
Congress intends to replace Obamacare before they commit to offering policies
for 2018, a new survey has found.
One of the biggest issues is the
individual mandate, which requires nearly all Americans to buy insurance or pay
a penalty. If Republican lawmakers repeal the mandate without a replacement
plan, insurers said they'd "seriously consider" withdrawing from the
market next year. Insurers see "significant" risks in remaining while
the details of a replacement bill are in doubt.
The effort to repeal major
portions of Obamacare, including the mandate, are already underway in Congress,
but Republicans remain divided over how to replace it. Senate Majority Leader
Mitch McConnell said Thursday that lawmakers are looking at including some
replacement measures in the bill.
Meanwhile, the White House also
has the mandate in its scope. President Trump issued an executive order last
Friday aimed at minimizing the health reform law's financial burden on
Americans, states and others. The Health secretary could try to weaken the
mandate by broadening the criteria for getting a hardship exemption.
The mandate is key to bringing in
younger, healthier enrollees, who can balance sicker, costlier consumers.
Already, insurers are finding their participants are sicker than expected,
which is among the reasons why they hiked premiums 22% for 2017.
Surveys show that as many as 40%
of enrollees say they wouldn't have signed up without the mandate, the Urban
report found.
If the mandate were eliminated,
insurers who remain would likely raise their premiums further. The prevailing
industry estimate is 5% to 15%, though at least one analysis put it above 20%,
one large insurer told Urban researchers.
Insurers are agnostic about
whether the Affordable Care Act should be repealed or not, and just want
clarity.
Urban Institute interviewed
executives from 13 insurance companies -- including large, for-profit carriers,
regional non-profits and others -- in December and early January, before Trump
took office.
Separately, the major insurers'
lobbying group wrote a letter to Congressional Republicans Tuesday, urging
lawmakers to approve incentives for Americans to continue their coverage,
particularly if insurers must cover those with pre-existing conditions.
America's Health Insurance Plans cited two states that prior to Obamacare
required insurers to cover the sick, but did not have an individual mandate. In
both cases, premiums skyrocketed and many insurers left.
Lawmakers are also looking to
loosen Obamacare's requirement that insurers take everyone, regardless of their
health history. Republican bills generally keep the protection for those who
have been continuously insured, while allowing carriers to levy surcharges or
require enrollees to wait six months before signing up. The lobby group wants
to define "continuous coverage" as having insurance for at least 12 months.
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