The consulting firm Avalere Health and The Associated Press crunched available state data, finding that “Obamacare’s” health insurance marketplaces seem to be stabilizing. Customers in some states will get price cuts. And the exodus of insurers from the program has halted, even reversed somewhat, with more consumer choices for 2019.
The steady outlook means the health care law won’t be an easy target for Republicans this year, an election issue that’s worked well for them since 2010. But Democrats may also be looking for new talking points. They can’t exactly argue that the Trump administration has wrecked the ACA, so they’re saying that popular provisions like protections for people with pre-existing conditions are still threatened.
The analysis found a 3.3 percent average increase in proposed or approved premiums across 47 states and
For next year, premiums are expected either to drop or increase by less than 10 percent in 41 states with about 9 million customers. Twelve of those states are expected to see a drop in average premiums, with
Insurers also are starting to come back. Nineteen states will either see new insurers enter or current ones expand into more areas. There are no bare counties lacking a willing insurer.
Even so, Chris Sloan, an Avalere director, says, “This is still a market that’s unaffordable for many people who aren’t eligible for subsidies.”
Nearly 9 in 10 ACA customers get government subsidies based on income, shielding most from premium increases. But people with higher incomes, who don’t qualify for financial aid, have dropped out in droves.
It’s too early to say if the ACA’s turnabout will be fleeting or more permanent. Either way, next year’s numbers are at odds with the political rhetoric around the ACA, still heated even after President Donald Trump and congressional Republicans failed to repeal the law last year.
Trump regularly calls “Obamacare” a “disaster” and declares it “dead.” The
The moderating market “takes the issue away from Republican candidates” in the midterm elections, said Mark Hall, a health law and policy expert at
Stability also undercuts Democrats’ contention that Trump has “sabotaged” the program. But Democrats say the ACA remains at risk while Republicans control
“Voters won’t think that the Trump threat to the ACA has passed at all, unless Democrats get at least the House in 2018,” said Bill Carrick, a strategist for Sen. Dianne Feinstein, D-
As if to add weight to Democratic arguments, the Trump administration has said it won’t defend the ACA’s protections for pre-existing conditions in a federal case in
In solidly Republican
Business analysts say the relatively good news for 2019 is partly the result of previous premium increases, which allowed insurers to return to profitability after losing hundreds of millions of dollars.
“They can price better, and they can manage this population better, which is why they can actually make some money,” said Deep Banerjee of
Repeal of the ACA’s requirement to carry insurance doesn’t seem to have had a major impact yet, but Banerjee said there’s “a cloud of uncertainty” around the Trump administration’s potential policy shifts. Yet some administration actions have also helped settle the markets, such as continuing a premium stabilization program.
April Box of Spokane
Box is self-employed as a personal advocate helping patients navigate the health care system. She has an ACA plan, but even with a subsidy her premiums are expensive and a high deductible means she’s essentially covered only for catastrophic illness.
“I’m choosing not to go to the doctor, and I’m saying to myself I’m not sick enough to go to the doctors,” Box said. “We need to figure out how to make it better and lower the price.”
Now in her 50s, Box was born with dislocated hips. She worries she could be uninsurable if insurers are allowed to go back to denying coverage for pre-existing conditions. She might need another hip surgery.
“It needs to be a level playing field for everybody,” said Box. “We need to have universal coverage — that is really the only answer.”
Last year, the state struggled to secure at least one insurer in every county. But approved rates for 2019 reflect an 11 percent average decrease. Two new insurers — Bright Health and Celtic— have entered its marketplace, and two others —Cigna and Oscar— will expand into new counties.
To calculate premium changes, Avalere and The Associated Press used proposed overall individual marketplace rate filings for 33 states and D.C., and final rates for 14 states that have already approved them. Data was not available for