News & Commentary

Health Plans Wary Of Coming Changes


As part of their frantic lobbying efforts, insurers warn that the Republican Congress and the Trump administration killing the ACA’s individual mandate may be a bridge too far. Insurers also worry that the incoming administration will do away with federal subsidies that help low-income Americans buy coverage on the exchanges. House Republicans have voted to block those subsidies.

“We could see a situation where no carrier would want to offer insurance,” Mario Molina, CEO of Molina Healthcare, tells the Wall Street Journal.

Kirk Zimmer is executive vice president of Sanford Health Plan. Sanford sells ACA policies in North and South Dakota. “We’d have a difficult time staying in the marketplace with the elimination of subsidies or the elimination of the individual mandate,” Zimmer tells the WSJ. In fact, for the most part, insurers want the individual mandate fines higher. Too many younger and healthier people who would broaden the risk pool decide to pay the penalty rather then enroll for coverage. No matter what transpires, insurers would need time to adjust. “We would love to see a three-year time frame, as long as possible,” Marilyn Tavenner, AHIP’s chief executive, tells the New York Times.

These are warning shots by the industry to legislators who’ve promised to repeal and replace. Replace it with what, exactly? Insurers warn that the administration would need to come up with a plan to make sure 22 million people are not left uninsured. Ten million of those have bought coverage on the ACA market.

Despite the departure of UnitedHealthcare and Aetna, AHIP still carries some clout on Capitol Hill, and GOP lawmakers are expected to listen carefully to its concerns, according to the Times.

As of this writing, though, too much is conjecture. “We’re doing some scenario-planning,” Joan Budden, CEO of Michigan-based Priority Health, tells the WSJ.

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