Insurers Pushing Trump Admin To Keep Obamacare Individual Mandate, Subsidies


By Sarah Hurtubise

Blue Cross Blue Shield Association lobbyists have been pushing the Trump administration to keep several Obamacare provisions that are good for insurance companies, while trying to get the law’s high taxes on them repealed for good.

The health insurance industry wants the Trump administration to preserve the Affordable Care Act’s individual mandate to purchase health insurance, as well as the subsidies available on Obamacare exchanges that cut down on the cost of premiums, according to Axios.

Blue Cross Blue Shield Association lobbyists told White House and Department of Health and Human Services officials on Feb. 6 that they’re hoping the administration keeps the individual mandate intact, at least until they’ve funded high-risk pools, limited special enrollment periods and established new rules for pre-existing conditions, according to a document that presents the actions the group is looking for on the health care law.

Republicans have staunchly opposed the individual mandate since Obamacare’s passage. They also have opposed cost-sharing subsidies based on income, as found in Obamacare, preferring financial assistance based on age.

Not only do insurers want the individual mandate, which obviously buoys the purchase of coverage, but the insurer group is pushing for the federal government to “do no harm” by keeping up the cost-sharing reductions that subsidize insurance premiums for Obamacare customers.

The insurance industry is also hoping the administration will step up to allow grandfathered insurance plans, with an extension currently slated to end in 2017, to remain in action. Grandfathered plans are those which were famously deemed insufficient by Obamacare regulations and have been phased out for years, despite President Obama’s infamous pledge that Americans would be able to keep their health plans under his namesake law.

They’re also looking for Congress to permanently repeal Obamacare taxes on insurance companies, citing the health insurance tax, medical device tax and a 3.5 percent user fee on Obamacare exchanges.

The Department of Health and Human Services is expected to release a rule on stabilizing Obamacare exchanges during Congress’s effort to repeal and replace the health care law, but it’s not yet clear what the content of the bill will be.

There may be a move to change the age band rating rule included in Obamacare. The Affordable Care Act limited insurers’ ability to charge older people, who typically use more health care services, more than younger people, capping the ratio at 3-to-1.

The age band ratio lowers the cost of insurance for older customers, but only by increasing the cost for young, healthy patients who typically require much fewer health care services. It’s possible the rule may increase the ratio to 3.49-to-1, while the insurance industry supports a legislative change to 5-to-1, which would require an act of Congress.

The Blue Cross Blue Shield Association strongly pushed the idea of increasing the age band, arguing that “young people are required to pay substantially more than the expected value of their coverage.”

If more young, healthy people choose to pay the Obamacare penalty to remain uninsured and forgoing insurance coverage, less healthy insurance pools remain and the higher premiums rise as a result. This has been a struggle for Obamacare exchanges, which have experienced large premium hikes as a result.

It’s possible the rule may increase the ratio to 3.49-to-1, while the insurance industry supports a change to 5-to-1.

Several Democratic senators sent a letter to HHS secretary Tom Price on Monday criticizing the potential rule change for allowing premiums to rise for seniors, asking that the shift be ruled out.

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