To paraphrase Mark Twain, reports of ACA’s (Obamacare) death are greatly exaggerated. Today, 216 members have voted on the newly amended House bill (AHCA). Senate Republicans have already expressed concern with the bill (primarily the end of Medicaid expansion by 2020, the implementation of high risk pools and issues with the modification of the pre-existing condition provisions). It is pretty logical to assume that the Senate will alter the House bill as the Senate has traditionally been a more moderate voice. If the bill is moved to the center by Senate Republicans, is there any certainty that the conservative Freedom Caucus will go along with it, it’s something to ponder. In reality, there will be a significant period of time that there will not be clarity on Health Care. For a very nice summary of how the AHCA may be modified, have a look at a nice summary from CNN.
What does that lack of clarity mean to Employers, Individuals and Insurance Carriers? For Insurance Carriers, the term “Growing uncertainty” keeps coming up as justification by Insurance Carriers for leaving or consider leaving State Based Exchanges. Everyone seems to be concerned about this issue, and logically, uncertainty is the worst thing that an Insurance Carrier can have when trying to provide insurance. If there is uncertainty, it is entirely logical to have them consider leaving State Based Exchanges until there is clarity so that they can understand the actuarial risk involved in providing an insurance product. Think about it, for any business if you are tasked with providing a service and you do not know the “rules of engagement”, what would you do?
The following are excellent articles on Insurance Carriers potentially leaving State Based Exchanges in 2018.
From an Insurance Carriers perspective on uncertainty, the following is an excellent article on Insurance Carriers push for clarity in their meetings with CMS on CSR payments in the future.
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