+ Regulatory
Ruth de Jauregui | Jun 21, 2017

Health care marketplace forecast brings call for more than just a fix

Jeremy Wynes, a Republican candidate U.S. representative in Illinois' 10th Congressional District, took to social media after the New York Times (NYT) estimated that 45 counties and up to 35,000 people would have no Affordable Care Act (ACA) carriers in 2018.

Wynes tweeted: "About time for some specificity, beyond just 'fix ACA', from our D.C. representatives twitter.com/nytgraphics/st…"

Illinois faced up to three-fourths of its counties having only one or two insurers offering coverage on the ACA exchange in 2017. After Aetna, UnitedHealthcare and its subsidiary Harken Health announced they were leaving the marketplace, Cigna stepped up and offered individual health plans on the ACA exchange for consumers in the Chicago area.

The NYT estimated that approximately 1,388 counties and 3 million people nationwide may have only one insurance carrier on the ACA exchange in 2018. The Kaiser Family Foundation provided the data used by the NYT in its analysis.

While some insurers, including industry giant Humana, are pulling entirely out of the ACA health insurance exchanges, Blue Cross-Blue Shield announced its plans to return to the marketplace. Health Care Service Corp. intends to sell the insurer's coverage in Illinois as well as several other large markets.

The uncertainty over federal funding has made insurers reluctant to commit to the ACA exchanges. The federal government has provided subsidies to the insurers so modest-income consumers can afford co-pays and deductibles. Those payments were separate from the income-based tax credits for consumers. President Donald Trump and Republican lawmakers have threatened to stop those payments.

Without a guarantee of the federal payments, insurers must factor in the possibility that the payments could end. This has resulted in estimated increases of nearly 23 percent in some states versus the approximately 9 percent if the companies were assured of the federal payments.

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