The health insurance industry is worried that any drastic changes to Obamacare would be dangerous, as the Republican-controlled Congress puts repealing the law on the top of its to-do list next year.
Republicans haven’t created a full replacement plan for the Affordable Care Act, but they can repeal the law easily through budget reconciliation or through administrative actions. Some analysts have said they expect a transition period until a replacement is passed, but the possibility of a repeal without any such period has left insurers jittery.
“Consumers should be covered and patients should be protected — and sudden disruptions would jeopardize both,” said Kristine Grow, spokeswoman for America’s Health Insurance Plans, the insurance industry’s main lobbying group.
Grow added that consumers need to have enough “time, flexibility and support so that any changes ensure safe and stable coverage.”
Republicans last year passed a budget reconciliation bill that would have gutted major parts of Obamacare, which was vetoed by President Obama. It included a two-year transition period to install a replacement, which would require 60 votes in the Senate to get approval.
While Republicans have signaled a desire to use reconciliation again to pass a repeal bill that would be signed by Trump, no legislation has been created or proposed.
The GOP currently has a two-seat majority in the Senate, meaning that any replacement plan likely would need Democratic support to pass.
Open enrollment has already started for the 2017 coverage year, and the Obama administration reported last week than 1 million people have signed up since it started Nov. 1.
While 2017 may be left intact, it is not clear what will happen for 2018 and whether insurers decide to remain in the law’s exchanges if they are going to be dismantled under a Republican replacement.
Some Obamacare insurers are losing money on the law’s exchanges. A study from the Commonwealth Fund think tank found that only one-third of Obamacare insurers were profitable in 2014, as a sicker-than-expected patient population drove up costs for most companies.
Large insurers such as UnitedHealth, Aetna and Humana left the exchange markets this year due to financial losses, but other insurers such as Anthem have stuck around hoping the marketplace will stabilize and eventually become profitable.
Health insurers in general would benefit from a full repeal of the law because they could extricate themselves from several policies, according to an analysis from the investment company Long/Short Investments.
Repealing the law would give insurers “greater liberty to formulate, price and sponsor policies that better mirror what might be expected from higher levels of free market competition,” the firm said.
Obamacare installed new regulations that mandated insurers to cover essential health benefits in plans offered on the law’s exchanges.
Those policies would likely go away under any Republican healthcare plan.
The plan that House Republicans released earlier this year goes into more detail than the plan offered by Trump. It calls for allowing insurers to sell across state lines, boosting health savings accounts and providing tax credits that are scaled to age as opposed to income, which is the case with Obamacare.
Grow said there is still “a lot to be learned about what policy changes will be proposed.”
The industry is open, however, to any changes to free up the marketplace.
“A competitive private market can deliver more choice, higher quality and lower costs,” Grow said.
