Navigation Link
Health Insurance
Basic InformationLatest News
Friday Is the Deadline for Obamacare 2018CVS-Aetna Merger Has Implications for Doctors' OfficesInsurance Ups the Odds of Beating CancerAs Tax Bill Unfolds, What's In Store for Obamacare's Individual Mandate?Will CVS-Aetna Merger Mean Cheaper Health Care?Differences in Cancer Survival by Type of InsurancePreventive Care for Adolescents Up Since ACA ImplementationNot 'Dead' Yet: Obamacare 2018 Sign-up Has BegunMany U.S. Cities Lack Health Insurance CompetitionObamacare Widened Access to Cancer CareMost Americans Shouldn't See Big Rise in Obamacare PremiumsTrump Signs Executive Order That Could Undermine ObamacareWhite House to Roll Back Birth Control Mandate in Employers' Health Care PlansInsurance Type Linked to Surgery Delay in MelanomaThe Unexpected Faces of the UninsuredFewer Uninsured Cancer Patients After Medicaid ExpansionRepublicans Abandon Health Reform BillAnother GOP Senator Says No to Latest Obamacare Repeal EffortInsurer Market Power Lowers Providers' PricesNarrow Networks in ACA Marketplace for Mental HealthHidden Gems in Your Health Insurance PlanNearly 25 Million U.S. Workers Now Have High-Deductible Health PlansRepublicans Take Another Run at Obamacare OverhaulObamacare Paid Off for Poorer Cancer PatientsMost People Not Bargain Hunters When It Comes to Health CareSenate Says No to 'Skinny' Obamacare Repeal BillNew Alcohol Screening, Brief Intervention Manual DevelopedSenate Rejects Repeal of Obamacare Without ReplacementSenate Prepares for Health Care VoteInsured, But Still Barred From Top-Tier Cancer CentersAs Efforts to Repeal Obamacare Fail, Future of Health Care Reform in LimboRevised Senate Bill Would Allow Bare-Bones Health PlansAmerican Adults Without Health Insurance Rises by Two MillionLack of Health Insurance Can Shorten Lives: StudySenate GOP Leaders Delay Vote on Health Reform BillSome Republicans Voice Concerns About Senate Replacement for ObamacareSenate Republicans Reveal Their Replacement for ObamacareHealth Insurers Recruiting Former Pharma Reps to Cut CostsLeading Medical Groups Mobilize Against Obamacare RepealUncertainty for Obamacare Plans as Filing Deadline Approaches4 in 10 Job-Based Health Plans in U.S. Are Now 'High-Deductible'High-Risk Pools May Represent Step Back for U.S. Health CareCBO: 23 Million Would Lose Health Insurance Under House Health Care BillObamacare a Win-Win for Poorer Adults: StudyCDC: Slowing of Decline in Number of Uninsured AdultsPeople With Pre-Existing Health Issues Fear Repeal-and-Replace BillIncreases in Rates of Insured Don't Harm Continuously InsuredGOP Health Reform Push Faces Uncertain Future in the SenateHouse OKs Republican Health Care BillAmericans Uneasy With Push to Repeal Obamacare: HealthDay/Harris Poll
Questions and AnswersLinksBook Reviews
Related Topics

Health Policy & Advocacy
Workplace and Career Issues

What's Next for the Obamacare Insurance Exchanges?

HealthDay News
by By Karen Pallarito
HealthDay Reporter
Updated: Feb 10th 2017

new article illustration

FRIDAY, Feb. 10, 2017 (HealthDay News) -- Americans who buy health insurance through the Affordable Care Act (ACA) marketplaces could have fewer health plan choices and face new enrollment hurdles and cost pressures in 2018, health policy analysts say.

Lacking clarity on the future of the ACA, also known as Obamacare, several large insurers say they are weighing their options for 2018.

Anthem Inc. CEO Joseph Swedish told investors during an earnings call last week that the company needs "certainty about short-term fixes" to the controversial health reform law to determine the extent of its 2018 participation.

Aetna Inc. CEO Mark Bertolini put it more bluntly, telling investors, "We have no intention of being in the market for 2018." However, he added that the company would participate "where we think it's appropriate."

Lydia Mitts, senior policy analyst at the health advocacy group Families USA, said it's difficult to say how insurers' decisions will play out from one region of the country to the next. "But I think it does leave everyone nervous about consumers having fewer choices in some markets in 2018," she said.

President Donald Trump says he intends to replace Obamacare with something better, but details of such a proposal have yet to be released.

In the meantime, health insurers that want to participate in the Affordable Care Act marketplaces next year must begin filing proposed health plans and rates for state regulatory review this spring.

They "need to know the rules of the road for 2018 in order to finalize their design of plan offerings and rates," explained Kevin Lucia, a research professor and project director at Georgetown University's Health Policy Institute in Washington, D.C.

If there are no clear rules, that uncertainty will be reflected in next year's premiums and insurers' decisions to participate, he said.

For example, ending the mandate requiring most Americans to have health insurance without replacing the Affordable Care Act could lead to significant premium increases for 2018, according to an analysis by Lucia and his colleagues.

The Trump administration reportedly is working on proposed rule changes to keep health insurers in the marketplace next year.

The administration will soon release a proposed regulation implementing several key changes, according to the news organization Politico. Based on draft documents, the administration is looking to charge older adults nearly three-and-a-half times more than it charges young adults, up from the current three-to-one ratio established under the law, the news source said.

Other changes contemplated by the administration could cut the annual enrollment period in half, tighten rules around special enrollments and loosen rules on the percentage of medical expenses that insurers must cover, according to Politico.

The Affordable Care Act's failure to attract sufficient numbers of young, healthy adults to offset the higher costs of insuring older, sicker members has been a persistent problem. Some insurers dropped out or scaled back their participation in 2017, citing sharp losses on ACA enrollment. Many others offered health plans but raised premium rates.

Caitlin Morris, Families USA's program director for health system transformation, said the reported Trump administration rule "would make coverage less affordable for consumers, particularly older adults in the marketplace."

AARP would consider suing the Trump administration if it advances a regulation charging older people more, The Hill reported on Tuesday.

The rule could also create new obstacles to enrolling young adults, Morris said.

"Younger adults coming off their parents' insurance at [age] 26 might enter through a special enrollment period that would require, under this proposed rule, additional documentation," she said. "And the more barriers you put up for young healthy adults to enroll, the less likely they are to do it," since young people generally don't have immediate health needs.

Despite the uncertainty surrounding the ACA, more than 12.2 million people have signed up for coverage this year, the Associated Press reported Thursday.

More information

This Georgetown University analysis examines health insurers' ACA participation and prices.