Insurers tell Congressional committee what they need to improve the ACA

Large and small insurers will testify before the Senate Health, Education, Labor and Pensions Committee this week to ask for measures they say will help stabilize the volatile health insurance market. Governors and insurance commissioners testified last week, Carolyn Johnson reports for The Washington Post. The committee is seeking a bipartisan solution to stabilize the exchanges set up under the Patient Protection and Affordable Care Act.

Millions of Americans depend on federally-subsidized marketplace plans for their health insurance, but major insurers have withdrawn from many mostly-rural counties, citing uncertainty about health care laws. Lawmakers may still attempt to repeal the ACA, but must do so by Sept. 30 to pass it with a simple majority. But insurers must submit their finalized plans for 2018 by the end of September, and are unsure what laws will be in effect next year. The current uncertainty doesn't just affect plans available for 2018. Insurers are already planning what plans will be offered in 2019.

Johnson lists some things insurers will probably ask for in testimony this week:

1)  Commit to paying the cost-sharing reduction subsidies that defray the cost of plans for lower-income Americans. This is a top priority for many insurers, Johnson writes. President Trump has threatened to stop paying these subsidies, projected to be worth $10 billion in 2018.

2) Extend a reinsurance program that provides payments to plans for people who have high medical costs. The program has been essential in keeping premiums down on those plans.

3) Enforce the individual mandate for health insurance and (possibly) reinstate the former advertising budget for ACA enrollment. Health insurers say they need a larger pool of insured people to keep premiums down for people who have high medical costs.

"Health insurers have plenty of other things on their wish lists. They'd like to abolish a tax that they say drives up premiums. They’d like to see states get greater flexibility and control over their marketplaces," Johnson writes. But the thing they want most from Congress and the administration is certainty.