Through deeds as much as words, much effort is being put into making the “Obamacare is in a death spiral” a self-fulfilling prophecy. What’s at stake:
- Threatening to Withhold billions of dollars in Cost Sharing Subsidies. Currently there is a ongoing lawsuit filed by Republican House Members against Health and Human Services from 2014 challenging the payment of the cost sharing subsidies
- Premium increases – a growing number of insurance companies are filing for double digit premium increase. This makes it more challenging for middle-class Americans to continue their health insurance as they earn too much to qualify for premium subsidies which are available to those who earn less than 250% of the poverty level (approximately $30,015 for an individual and $61,500 for a family of four).
- Not Enforcing the individual mandate. The IRS has been instructed to back off enforcement of the requirement that most people have health insurance or pay a penalty. The IRS did not require tax returns to specify if a person had health insurance under the ACA. Technically, the IRS has stated that taxpayers are still legally required to have health insurance or pay the penalty and that they have discretion to follow up on this. Given that this is the case, it is still prudent to specify this in a tax return just in case this is changed.
- Defaulting on “risk corridor” funds. These were set up under the ACA to be paid to insurance companies who enrolled more than their expected share of sick people. Insurers are still owed millions and many have sued the US government to get paid. Judge certifies insurer’s risk corridor case as a class action. This goes back to 2015, as the GOP Congress Weakens Obamacare by limiting “bailout” Funds for Insurers.
- Cancelling ads for open enrollment in January. Many people wait until the last minute to sign up and having these ads pulled almost certainly affected enrollment for 2017.
A growing number of insurers are asking for double-digit premium increases or deciding to leave the market altogether. As commented by Brad Wilson, CEO of Blue Cross Blue Shield of North Carolina commented: Insurance CEO: I’m raising Obamacare premiums because of Trump. Anthem said Tuesday that it was pulling out of the Ohio marketplace, where it serves more than 10,000 customers, next year. Other companies that have left the health exchange market for 2018 include Aetna and Humana. If a company sells an “off-exchange” policy, you cannot obtain a cost-sharing subsidy.
If the individual market “crashes”, it is estimated that over 15 million people would lose coverage. And while most analysts say the market probably would eventually rebound, in the short term things could get messy. “Is the administration doing what it needs to do to stabilize the market? No, they’re doing the opposite,” says Kevin Counihan, CEO of the insurance exchange program during the Obama administration, because Before Republicans replace Obamacare, the White House is killing it.
Insurance commissioners are trying to come to the rescue as States Scramble to prevent ObamaCare Exodus. State insurance commissioners have implemented later filing deadlines for rate filings along with allowing for dual premium requests – one set that assumes the continuance of the ACA with cost-sharing reduction payments and the enforcement of the individual mandate and a second set that assumes both are discontinued.
The most pressing issue is that whatever Congress decides to do, there’s almost no chance it will formalize that decision before June 21, the deadline by which insurers have to decide whether they want to participate in the ACA’s exchanges next year and, if so, how much to charge. That means they’re likely to play it safe, either with substantial premium hikes or by bailing on certain exchanges altogether. The New York Times reports that the Senate bill may fund the ACA’s cost-sharing reduction subsidies. The only catch, of course, is that there’s no way insurers will know by June 21 whether the full bill is going to pass.
Senate Speaker Mitch McConnell (R-KY) said he is striving to get a vote on the Republican health care bill by July 4, before Congress leaves for August recess. As ludicrous as this deadline seems, the Senate could pull it off — but it will be done without much public scrutiny. Sen. McConnell implemented Senate “Rule 14” Wednesday to fast-track the GOP House health bill. This rule allows the Senate to skip the committee process (goodbye full senate committee debate) and instead “fast-tracks” the bill by moving it on the senate calendar so it can be brought to a vote.
Republicans need to pass a health care bill immediately. And they need to pass a bill that reconciles the needs of both the House and Senate, by September 30th in order to use reconciliation. Reconciliation is a 1974 act that expedites the senate’s consideration of bills that pertain to the budget. While Washington watches James Comey testify before the Senate Intelligence Committee, Senate Republicans leaders and the health care working group will still be meeting for a working luncheon to continue negotiations. While you focus on Comey, Senate Republicans are launching an audacious plan to pass Trumpcare as McConnell whips Senate GOP back in line on Obamacare repeal. And in some good news McConnell Said to Back Obamacare Pre-Existing Illness Policy.
Now we know why the Republicans rushed through the A.H.C.A. without waiting for the C.B.O. score and knowing that most likely that the plan would not make it through the Senate, it was simply a political ploy to back up their claim that “Obamacare is in a death spiral”. Remember, there is no Obamacare, just the Affordable Care Act, this is all part of the political game taking place. The goal was to create uncertainty into the marketplace among insurance companies making it a self-fulfilling prophecy.
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