Two weeks before open enrollment begins, CMS' Acting Administrator Andy Slavitt discussed his expectations and predicted challenges leading up to the Nov. 1 start date on Politico's Pulse Check.
Below are three thoughts from Mr. Slavitt, as told to Politico.
1. The No. 1 concern for open enrollment 2017 is "definitely outreach," Mr. Slavitt said. He said the top three untapped uninsured groups are the working poor, the chronically uninsured and a group dubbed "the new economy," or entrepreneurs and contractors not tied to one job.
"Pockets of people, immigrants, young people … they're people who are in different sectors. We're getting smarter about who those people are," Mr. Slavitt said. "We need to make dents in [those] groups every year."
In terms of those in the third "new economy" pocket, Mr. Slavitt told Politico that people forget the marketplace is for that population as well. "The president and the leaders from Congress, when they were talking about the Affordable Care Act and putting this together, part of the rationale was to make sure our economy cannot be so tied to this job lock idea," he said. "And these are people that will come and go [from the marketplace]. Some will come in for a few months, some will come in for a year … and the up and down I think you see in the marketplace is actually a very healthy thing."
2. Minnesota Gov. Mark Dayton (D) does not have it "exactly right." Last week, Gov. Dayton said the ACA is "no longer affordable to increasing numbers of people." Mr. Slavitt told Politico he thinks that claim is not entirely accurate.
"Rates are going up in 2017 to a greater extent than they did in 2015 and 2016. So why are they going up? The largest reason is that rates were underpriced for the first couple years of the marketplace," he said.
"So before you start thinking about risk pools and young people, remember that we've never covered sick people before in this country, no questions asked. I don't think we know how much it would cost," Mr. Slavitt said.
3. Rate increases may be high, but the real concern is healthcare costs in general. Mr. Slavitt said premium rate increases are about 18 percent below what the Congressional Budget Office's has estimated. He said "in a more perfect world where we had better data, rates would have started 10 percent higher, rates would have gone up a little bit more in 2015, they would have gone up a little bit more in 2016 and we would have had a smooth landing here. That would be better. But we don't."
He said the question people should be asking is, "Why is healthcare not affordable enough for everybody to be able to afford it? That's a question we've had to ask before the ACA. I think the ACA made some of these things visible but certainly didn't cause them."
To listen to the full Politico Pulse Check interview, click here.
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