Administration Pushes Conservative Goals in Health-Care Market Changes
Insurers May Now Charge Higher Premiums to Seniors
The administration would like to see the ACA market to reign in some features, such as allowing insurers to charge higher premiums to older people. Suggested changes include:
1- Allowing insurers to charge older people five times as much as younger people
2- Expanding access to health savings accounts and increasing the amount of money that people can contribute to them
3- Supporting a permanent congressional appropriation for subsidies to insurance companies who decrease deductibles and co-pays for lower-income consumers in exchange for explicit exclusions on abortion coverage by those insurers.
The ACA currently restricts insurers to charging older buyers three times as much as younger ones, which has checked premiums for 50-somethings and 60-somethings compared with what they might have been otherwise. Insurers contend this has increased premiums for healthier 20-somethings and 30-somethings to the point that they don’t want to buy coverage, forcing premiums up across the board.
Federal courts are still wrestling with questions over whether insurer subsidies for low-income buyers’ cost-sharing are lawful without an explicit congressional appropriation to the 2010 health law. The administration recently instructed subsidy payments to stop which caused some insurers that had counted on the subsidies to further raise premiums.
The administration plans to back lawmakers if they opt to fund the payments, but insists that such a move include shields on abortion coverage.
The administration also wants any ACA stabilization plan to allow for the renewal of short-term plans that don’t comply with the health law, so these plans can operate more like traditional insurance. And it wants to block funding from organizations that may have a role in abortion insurance coverage or procedures.
That timing is critical, because the legislation must pass before insurers set their 2019 rates, which occurs as early as May 2018 in some states.
The administration seeks a stabilization plan that includes changes to health-savings accounts (tax-free accounts used by consumers who have insurance policies with high deductibles). These changes could include raising the amount that people can contribute to the accounts or allow them to use the plans for chronic conditions before hitting their deductible.
An ACA stabilization plan would restore billions of dollars in subsidies that insurers were getting to help pay for subsidies for lower-income consumers.
WSJ – 3-7-18