Key players in the U.S. health insurance market told Congress on Wednesday to tread carefully with Obamacare, saying the law hasn’t worked as intended but clumsy repeal efforts could made a stressed marketplace even worse.
Lobbyists and regulators said lawmakers should sketch out a plan by March so insurers can calculate their prices for 2018 options.
“Insurance markets do not respond well to uncertainty,” Tennessee Insurance Commissioner Julie Mix McPeak told the Senate Health, Education, Labor and Pensions Committee.
Republicans have approved a budget that calls for a repeal of the Affordable Care Act, but party leaders are struggling to come up with a market-oriented alternative.
Marilyn Tavenner, who oversaw Obamacare’s rollout in 2013 and who now leads the nation’s top insurers’ lobby, said the marketplace has failed to attract enough young and healthy customers, spawning “serious challenges.”
But she said millions of Americans have become insured through the program, and she urged Congress to keep funneling taxpayer money to help people buy insurance while Congress plots the next steps.
“The absence of this funding would further deteriorate an already unstable market and hurt the millions of consumers who depend on these programs for their coverage,” said Ms. Tavenner, who joined America’s Health Insurance Plans as president and CEO in 2015.
Committee Chairman Lamar Alexander, Tennessee Republican and key Obamacare opponent, acknowledged the thorny path ahead.
His party wants to scrap the law entirely but doesn’t want to drive insurers out of the marketplace during the transition to an alternative. Republicans may have to fund cost-sharing payments to assist lower-income enrollees or “reinsurance” payments to plans that take on high-cost enrollees in the near term.
About one-third of U.S. counties have just one insurer on their Obamacare exchanges.
“It’d be like having a bus ticket in a town where no buses run,” Mr. Alexander said.
Ms. McPeak said the chairman’s home state is reeling from soaring rates and dwindling choices under Obamacare, so Congress should allow insurers to provide cheaper plans with fewer benefits, or relax rules that have prevented insurers from charging older consumers more than three times what they charged younger enrollees. Republicans say a 5-1 ratio is more realistic.
She said the ultimate plan should “minimize surprises.”
Both parties are buckling in for turbulence.
Mr. Trump issued an executive order targeting the law within hours of taking office. Then, he yanked up to $5 million in ads touting the main Obamacare website, HealthCare.gov, ahead of Tuesday’s deadline for 2017 coverage.
Democrats contend the president is sabotaging Obamacare to paper over shaky Republican replacement plans.
“If they continue rushing to take away families’ health care, with no alternative plan, they will be fully responsible for the chaos and the uncertainty that Trumpcare is already causing and will continue to cause,” said Sen. Patty Murray of Washington, the ranking Democrat on the health committee.
Republican leaders hope to get support from at least eight Senate Democrats to pass Obamacare replacement bills in the coming months while relying on Mr. Trump to smooth the transition through executive action.
One sticking point is whether to retain an array of taxes Obamacare imposed to pay for its coverage provisions so Republicans can fund their own plans.
Democrats, meanwhile, have balked at outright repeal, saying Congress should instead consider fixes that expand the federal government’s footprint in health care, including more generous subsidies or a government-run “public option” to compete with private plans on the exchanges.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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