ORLANDO, Fla. — The CEO of a major insurance and health company in Florida said Friday that both political parties failed to make improvements to Obamacare during debates over the healthcare law in recent years.
“Democrats didn’t want to talk about what was wrong with the Affordable Care Act and Republicans didn’t want to make it better,” said Pat Geraghty, chief executive officer for GuideWell Mutual Holding Corp. and Florida Blue. “We came away thinking, ‘Who is working for the American people on this?'”
Speaking on a panel at the annual conference for the Association of Health Care Journalists, Geraghty spoke of meeting with lawmakers on Capitol Hill and the challenges that insurance companies face, particularly in regard to whether the Trump administration or Congress will allow for payment of cost-sharing reduction subsidies. The Obamacare-created payments allow insurers to reduce out-of-pocket medical expenses for low-income enrollees, and their future is uncertain as Congress debates dismantling Obamacare and the spending bill approaching next week.
“We want to be in the market for 2018,” Geraghty said. “We are watching very closely what’s going to happen in Washington, D.C. The CSR is absolutely critical to what happens next. Our position is that we will probably be playing but we need to see what happens.”
Also speaking on the panel was Mario Schlosser, chief executive officer for Oscar Health, which sells plans in the federal exchange in Texas and on the state exchanges in New York and California. Because the insurance payments have not been guaranteed, he was not able to say whether the company would stay in the exchanges next year, but that it wanted to.
“We’re going to fight extremely hard for there to be a stable individual market,” he said.
“This is a good market to be in and you can make it work. We have been able to work … it has been much more stable,” he later added.
Oscar Health was co-founded with Josh Kushner, the brother of President Trump’s son-in-law Jared Kushner, but he has no operational role in the company.
The question over the payments will affect how many insurance companies sell plans in the exchanges, which affects prices and options for consumers. Doug McKeever, chief deputy executive director for Covered California, the largest state-based exchange, said during the panel that the 11 insurers that sell plans in the state have expressed concerns about whether they will receive the payments. The plan prices are due May 1 in the state, earlier than the June deadline for the federal exchange.
“You can imagine there is a great deal of angst among insurers about how they are going to price their products … we have not heard from any that they are leaving,” he said.
Health insurers met with Seema Verma, administrator for the Centers for Medicare and Medicaid Services, this week to communicate the need for the payments, which are expected to total $7 billion in 2017.
The future of the cost-sharing reduction subsidies is uncertain because of a lawsuit filed by House Republicans when Barack Obama was president, which accused the administration of illegally distributing the payments. A federal judge sided with the House, and the Obama administration appealed the ruling.
On Friday, Office of Management and Budget Director Mick Mulvaney offered Democrats the insurance payments in the spending bill in exchange for funding for a border wall between the U.S. and Mexico.
Matt House, communications director for Senate Minority Leader Chuck Schumer, D-N.Y., called that approach a “non-starter.”
