Questions around ACA replacement put insurers in strategic deadlock: 5 things to know

Morgan Haefner - Print  | 

While lawmakers wage efforts to repeal and replace the ACA, health insurers are questioning what a replacement will look like — leaving many with limited strategies, such as sustaining their ACA exchange operations or completely exiting the market, Bloomberg reports.

Here are five things to know

1. Most payers will face challenges to sustain their health plan offerings on the ACA exchanges, according to the report. Insurers must file plans with state and federal officials to participate on the 2018 exchanges starting in April, the same month Congressional Republicans are projecting a replacement may be ready.

2. Researchers at Georgetown University in Washington, D.C., interviewed 13 payers across 28 states regarding their preparations for ACA repeal. The study's lead author Sabrina Corlette said insurers are "frustrated" and "just need to know what the rules are."

3. A lack of details regarding what the health law's replacement will look like has left some insurance executives contemplating whether they should pull their individual health plans from the exchanges altogether. Aetna Chairman and CEO Mark Bertolini said the Hartford, Conn.-based payer will not offer health plans in the exchanges it exited this year and may further slim its participation in 2018 "given the unclear nature of where regulation's headed."

4. Certain actions like President Trump's executive order to immediately minimize the ACA's economic burden and HHS' brief efforts to halt ACA health plan outreach have left payers questioning whether the administration will sustain or weaken the exchanges, according to the report. Michael Neidorff, CEO of St. Louis-based Centene, said the insurer will continue providing health plans on the public exchanges if the markets don't weaken by the fall.

"It's business as usual, until we hear otherwise," Mr. Neidorff told Bloomberg."We just take calculated risks, and on this one, they're not going to leave 20 million people uninsured."

5. J. Mario Molina, CEO of Long Beach, Calif.-based Molina Healthcare, said he is wary of lawmakers' proposed replacement initiatives, such as further emphasis on health savings accounts and high-deductible health plans. 

"I don't think those things, as much as the Republicans like them, are going to be as popular as they think with low-income people," he said. "Right now, people hate these high-deductible plans."

Molina mostly offers Medicaid plans and ACA health plans for low-income individuals.  

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