As health insurers across the country begin filing their proposed rates for 2019, one thing is clear: The market created by the Affordable Care Act shows no signs of imminent collapse in spite of the continuing threats by Republicans to destroy it.
In fact, while President Trump may insist that the law has been “essentially gutted,” the A.C.A. market appears to be more robust than ever, according to insurance executives and analysts.
.. regulators are not grappling with the prospect of so-called “bare” counties, where no carrier is willing to sell A.C.A. policies in a given area.
.. “The market is in a better position now than it has ever been since the exchanges have opened,” said Deep Banerjee, who follows insurers for S & P Global Ratings. The companies first began selling policies in the state exchanges, or marketplaces, five years ago. After years of losses, the insurers are now generally making money.
.. A midlevel policy in Baltimore could cost $622 a month, roughly a third higher than the average of the other states reporting to date.
.. A midlevel policy in Minneapolis is priced at $302 a month.
.. The Justice Department recently sided with the Republican states in arguing that the provisions protecting people with existing medical conditions are unconstitutional, which would upend the market entirely.
.. Insurers in Pennsylvania are seeking average increases of just under 5 percent
.. People whose income levels are low enough to qualify for federal tax credits are largely insulated from price hikes ..
.. the number of people buying A.C.A. plans at full price dropped by roughly 20 percent from 2016 to 2017
.. Premiums soared an average of about 30 percent in 2018 for those who did not qualify for a federal subsidy.
.. with 10.6 million customers buying plans in the state marketplaces for 2018.
.. the overwhelming majority — 9.2 million — qualify for some federal assistance.
.. Centene, the market’s largest player with 1.6 million customers, to Oscar Health, the venture-backed outfit that struggled in the early years, are expanding next year. More than a dozen carriers are entering new markets.
.. The company wants to nearly double the number of places where it sells policies, including entering three new states: Arizona, Florida and Michigan.
.. doing away with the so-called individual mandate that encourages healthier people to enroll. The administration has also been pushing the adoption of much cheaper and flimsier policies that compete with A.C.A. plans by issuing new rules on association plans.
.. Without the administration’s actions, he said, rate increases would have been in the single digits for 2019.
.. In New York state, about half of the 24 percent increase being sought by insurers is because of the removal of the mandate. Insurers think fewer healthy people will enroll
.. Underlying medical costs are forecast to go up around 6 percent next year, in line with recent increases
.. the percentage of people who are uninsured appears not to have grown since Mr. Trump took office: it’s been about 9 percent since 2015.
.. insurers are increasingly comfortable with the current state of the market.
.. Most insurers think the Republicans will not be successful in their legal efforts to undo the law, and they are holding off on making any dramatic moves.
.. “The big game changer would be the lawsuit in Texas,”
.. insurers are discovering their customers were loyal.
.. “Last time, they tried everything,” said Michael Neidorff, the chief executive for Centene, including eliminating the subsidies aimed at reducing people’s out-of-pocket costs if they were low income and slashing the outreach efforts. But Mr. Neidorff said the vast majority of people remained enrolled. “People want insurance,”
.. Those who can afford coverage are also remaining because they have little choice. “It’s a very price inelastic set of enrollees,”
.. says insurers have become less concerned about the price increases
Health Care Fantasyland
Why is the Republican Party having a Groundhog Day experience on health care, with its House leaders continuing to push for a bill only to go through the same cycle of having their own members rebel?
Because top Republicans still aren’t willing to grapple with reality.
They have spent years pretending that it’s easy to fix the health care system and lying about both Obamacare and their own proposals. They’re still doing it.
.. Ryan insisted — with no factual basis — that the new bill would protect the sick.