Health Insurers Willing
to Give Up a Key
Obamacare Provision
by- Lobby group is open to repeal of individual insurance mandate
- AHIP wants incentives to buy insurance, continued payments
Trump's Health-Care Vision: The Winners and the Losers
U.S. health insurers signaled Tuesday that they’re willing to give up a
cornerstone provision of Obamacare that requires all Americans to
have insurance, replacing it with a different set of incentives less loathed
by Republicans who have promised to repeal the law.
Known as the “individual mandate,” the rule was a major priority for the
insurance industry when the Affordable Care Act was legislated, and also
became a focal point of opposition for Republicans. In a position paper
released Tuesday -- the first since President-elect Donald Trump’s victory --
health insurers laid out changes they’d be willing to accept.
“Replacing the individual mandate with strong, effective incentives, such
as late enrollment penalties and waiting periods, can help expand coverage
and lower costs for everyone,” AHIP said.
That also includes openness to Republican ideas such as an expanded role
for health-savings accounts and using so-called high-risk pools to cover
sick people. In return, insurers are asking Republicans to create strong
incentives to buy insurance, and to ensure the government continues to
make good on payments it owes insurers under the ACA. The paper was
released by America’s Health Insurance Plans, or AHIP, the main lobby
for the industry.
“Millions of Americans depend on their current care and coverage,” AHIP
said in the document outlining its positions. The group called on lawmakers
to “ensure that people’s coverage -- and lives -- are not disrupted.”
Republican Replacement
Now that they’re set to gain control of the White House, Republican
lawmakers are working to define their vision for replacing the law after
years of attempts to repeal it. Obamacare brought insurance coverage to
about 20 million people via an expansion of Medicaid and new insurance
markets, and repealing the law without a replacement would leave those
individuals without coverage.
Trump has said that repealing and then replacing the law will be one of
his first priorities. Republicans in Congress, however, have signaled that
they’ll need time to write a replacement -- potentially via a years-long
delay between passing a repeal and implementing it -- to craft a replacement.
And AHIP on Thursday said insurers will need at least 18 months to create
new products and get them approved by state regulators, if Republicans
change the market. It could take even more time to educate consumers
and change state laws, AHIP said.
“It’s taken six years to get where we are now and to demonstrate the
failure of Obamacare, so it’s going to take us a little while to fix it,” said
Senator John Cornyn of Texas, a member of the Republican leadership
in the chamber.
Medicaid Changes
Republicans may also make substantial changes
to Medicaid, by turning the joint state-federal
program into one where the U.S. sends “block
grants” to the states, which exert more control.
Vice President-elect Mike Pence said on CNN
Tuesday that the Trump administration will “develop a plan to block-grant
Medicaid back to the states” so they can reform the program. Some Medicaid
programs are administered in part by private insurers.
AHIP said any such plans should ensure that payments are adequate to meet
the health needs of individuals in Medicaid coverage. And they should ensure
that when enrollment increases in an economic downturn, funds are
available to help states deal with the increased demand, AHIP said.
AHIP is open to working with Congress on replacement plans for the ACA,
said Kristine Grow, a spokeswoman for the lobby group. The document is
the first detailed look at AHIP’s priorities.
Big insurers like UnitedHealth Group Inc. and Aetna Inc. are already
scaling back from the ACA’s markets, because they’re losing money. At the
same time, remaining insurers are boosting premiums by more than 20
percent on average for next year.
Trump’s election increased the level of uncertainty in the market, and a
repeal bill without something to replace the law could destabilize it
further. To shore up insurance markets, AHIP says lawmakers should
fund a program, known as reinsurance, designed to help insurers with
high costs, through the end of 2018, and avoid cutting off cost-sharing
subsidies for low-income individuals.
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