As repeal of “Obamacare” stalls in Congress, Montana health insurers now are wondering what steps the Trump administration will – or won’t – take to affect the cost of policies for individuals buying their own health coverage.
They say if the current elements of Affordable Care Act – “Obamacare” – are carried out, these markets should be OK.
“I think it actually will have stabilized and it will go along just fine,” says Larry Turney, president of the Montana Health Co-op, which insures about 22,000 people in Montana with individual policies.
But if the Trump administration halts federal payments that offset costs for low-income customers, or doesn’t enforce the mandate requiring individuals to buy health coverage, rates for individual policies will increase more in 2018, they say.
“If the administration eliminates the (cost-sharing payments), that’s not letting the ACA implode on its own,” Turney told MTN News. “That’s giving it a lot of help to implode, and that’s not necessarily a good thing.”
The 70,000 Montanans who buy their own health coverage are a small portion of the overall health-insurance market, but are the ones who’d be most affected if the Trump administration decides Obamacare should “collapse” or “implode.”
John Doran, spokesman for Blue Cross and Blue Shield of Montana, says the 32,000 people who buy individual policies from Blue Cross are about one-tenth of its overall business.
However, they’re the ones that draw all of the attention in discussions about the ACA, he says. Employer-group plans are by far the biggest part of the health insurance market, but are largely unaffected by the federal law.
PacificSource, the other insurer selling individual policies in Montana, covers about 12,500 people in this market. Altogether, the individual market accounts for just 6 percent to 8 percent of the health insurance market in the state.
A key part of Obamacare is something called “cost-sharing payments,” or CSRs. The payments go directly to insurers and help offset out-of-pocket costs for those buying individual policies and earning less than 250 percent of the federal poverty level (about $30,000 for a single person).
President Trump has said the administration will decide soon whether to continue making these payments to insurers, and has suggested that he may cancel them.
If the CSRs are canceled, the Montana Health Co-op – whose business is almost entirely individual policies – would lose $1.8 million a month and have to raise its rates substantially for 2018, Turney says.
Blue Cross has already assumed the CSRs won’t be made, and filed earlier this month for an average 23 percent increase for its 2018 rates for individual policies.
Doran says if the Trump administration comes through on approving the CSRs, Blue Cross rates for individual policies in Montana will have a much lower increase next year.
“We need certainty from the administration to make sure that the ACA rules and regulations as we know them are going to be in effect for 2018,” he told MTN News.
Congress also could take action to ensure the CSRs or other actions to shore up the individual market will occur, but time is running out. Insurers must set their 2018 rates in the coming weeks, and the U.S. House is taking an August recess and is not scheduled to return until after Labor Day in September.
“If they do (anything) after August, it leaves us with very little time to make any kind of adjustments for 2018,” Doran says.