Insurers told Seema Verma, administrator for the Centers for Medicare and Medicaid Services, during a meeting Tuesday that the most pressing issue for their business was whether the federal government would continue to pay subsidies that help insurers reduce out-of-pocket costs for lower-income enrollees.
While insurance company representatives said they discussed a variety of offerings through Medicaid, Medicare and employer plans, they have pressed the Trump administration to continue to distribute the funds, called cost-sharing reduction subsidies, which are at the center of a House lawsuit that was brought against the Obama administration.
Without the funds, which are expected to total $7 billion in 2017, insurers would look to exit the Obamacare-created exchanges as soon as they are able and would raise premiums.
Insurers did not disclose whether the administration gave them any reassurance on the matter.
Trump said last week that he might withhold the funds as a way to bring Democrats to the negotiating table on legislation to gut Obamacare. The comment concerned insurers as well as healthcare providers, who could face an increase in uncompensated care.
Kristine Grow, spokeswoman for America's Health Insurance Plans, said the payments were the group's "most pressing concern" and that the organization reiterated the importance of getting certainty about the funds during its meeting with Verma.
Other insurers at the meeting included Molina Healthcare, Geisinger Health Plan and the Blue Cross Blue Shield Association. Oscar Health Insurance, which was co-founded by Josh Kushner, brother to Trump's son-in-law Jared Kushner, also attended.
Health insurer Aetna was not at the meeting, but the company's CEO, Mark Bertolini, had a one-on-one meeting with Verma a few weeks ago, according to a company spokesman.
Groups did not disclose whether they discussed the health insurance tax created under Obamacare, which also has been a top concern for insurers. The tax was deferred this year but is scheduled to go into effect next year, and companies have said that implementing it would result in cost-shifting to consumers in the form of premium increases.
The meeting with Verma was held as insurers are preparing to submit their plan prices as early as May in some states and face uncertainty on various fronts as Republicans work out the details of the American Health Care Act, a bill that would undo major portions of Obamacare. Whether the cost-sharing subsidies are distributed and whether the health insurance tax is repealed would affect the pricing of the plans they offer.
Mario Molina, CEO of Molina Healthcare, said the talk included a conversation about Medicaid and exchange plans."Our objective remains the same — to help millions of Americans access the health insurance they need at an affordable cost," he said. "And we will work closely with CMS and the administration so that we can continue to fulfill our mission of providing quality care to people receiving government assistance."
The Centers for Medicare and Medicaid Services last week issued a final rule that addressed concerns insurers had about the exchanges, including relaxing some rules and tightening loopholes in the system. Though insurers welcomed the move, the uncertainty from the Trump administration and Congress could result in additional companies leaving the exchanges, which would result in fewer options for customers and price increases for the smaller share of enrollees who do not qualify for tax subsidies to help them pay for plans.