How Trump insurance changes could affect coverage next year

A final rule released Thursday was supposed to help stabilize the marketplace created by the Affordable Care Act in lieu of any resolution to repeal and replace the healthcare reform law.

The president thought he could intimidate Democrats into helping him salvage Trumpcare by threatening to withhold insurer subsidies and letting Obamacare implode. President Donald Trump could drop the Obama administration's appeal of the ruling and halt the payments.

"I don't want people to get hurt", Trump told the Journal.

While insurers were happy with the rule, they pressed the administration to guarantee funding for the cost-sharing subsidies.

An estimated 21 percent of individual market plan members stopped premium payments in 2015, and almost 90 percent purchased new plans in 2016 - about half purchased the same plans they had stopped payments on, the proposal says.

Americans who get their health insurance through the exchanges set up by the Affordable Care Act may have more difficulty finding a doctor next year, but it won't necessarily have anything to do with insurers leaving the system.

In tax filings for 2015, about 5.3 million taxpayers had to pay the government because they got too much in tax credits, compared to 2.4 million who got additional money back. "No, I don't think it goes far enough", said Condeluci, a former staffer to the Senate Finance Committee who specialized in insurance issues.

Numerous changes announced Thursday follow recommendations from insurers, who wanted the government to address shortcomings with markets, including complaints that some people are gaming the system by signing up only when they get sick, and then dropping out after being treated. "Health plans and the consumers they serve need to know that funding for cost-sharing reduction subsidies will continue uninterrupted". How big a tax increase Lara's bill would require remains uncertain, given the lack of detail included. The 2018 enrollment period will begin November 1 and run through December 15.

Still, health plans say the rule is a first step at addressing the concern of sicker people flooding the marketplace to pick up insurance for the sole goal of covering expensive services and then dropping coverage.

-Allowing an insurer to collect past debt for unpaid premiums from the prior 12 months before applying a consumer's payments to a new policy.

Open enrollment for next year would shorten to six weeks, down from three months.

- Curbs on "special enrollment periods" that allow consumers to sign up outside the normal open enrollment window.

GOP House leadership said it's hopeful they will be able to garner enough votes to pass legislation soon, but doesn't want to put an "artificial timeline" in place in fear it might derail their progress.

Thursday's final rules are largely similar to a version initially proposed in February, before the Republican repeal attempt failed.

One big problem in boosting enrollment is that many potential consumers — particularly younger, healthier ones — say premiums are too high.

The health law uses a complex formula dividing plans into metal tiers — bronze, silver, gold and platinum — based on an average percentage of a typical years health care bills they cover.

Most communities will have competing insurers on the public marketplace next year, but a growing number will be down to one, and some areas may face having none. Several major insurers, including Humana and Aetna, have announced plans to exit some state exchanges in 2018. He said he hadn't decided whether to continue funding cost-sharing subsidies that reduce deductibles and out-of-pocket costs for low-income consumers.

  • Joanne Flowers