The Swine Line: The Staff Blog of Citizens Against Government Waste

No, Obamacare's Problems Are Not Over

The Swine Line is the staff blog of Citizens Against Government Waste (CAGW) and the Council for Citizens Against Government Waste (CCAGW). For questions, contact blog@cagw.org.

Last Wednesday, August 23, 2017, the Centers for Medicare and Medicaid Services (CMS) announced that only one county, Paulding County, Ohio, would have no health insurers participating in the Patient Protection and Affordable Care Act (ACA), or Obamacare.  Admittingly, this was a very different scenario from what was anticipated just a few months ago.  In June, the New York Times reported, based on their own analysis, that there would likely be 45 counties with no carriers to choose from in the Obamacare marketplaces and that 1,388 counties could have just one health insurer.  Kaiser Family Foundation made a similar forecast.  Insurer after insurer had announced in the past year it was either pulling out of some state exchanges or considering not participating in ACA at all in 2018.  It became clear Obamacare was in deep trouble and it would come as no surprise that citizens in certain areas of the country would have no access to an insurer via an Obamacare exchange. (Keep in mind the exchanges are the only place where consumers can get their premium subsidized by taxpayers.)

But on Thursday, it was announced that Paulding County citizens would have access to an insurer.  The Washington Post reported, “An anti-Obamacare argument evaporates:  No counties now lack exchange insurers.”  This caused many Obamcare supporters to believe there is no longer a death spiral in Obamacare, that the marketplaces are stabilizing, and the healthcare law’s troubles are over.  Don't believe it. 

The Post did not go into any detail about the other part of CMS’s message and that is it is “projected that 1,478 counties - over 45 percent of counties nationwide - could have only one issuer in 2018. This could represent more than 2.6 million Exchange participants with only one health insurance option, which means they will not have any choices.”  That should not be very comforting for many consumers and taxpayers since no competition means higher prices.

Why did Paulding County and other counties suddenly get insurers participating in Obamacare?  According to the August 24 Washington Examiner, while large insurers such as Anthem have pulled out of Obamacare, smaller insurers such as CareSource and Centene stepped in to provide coverage in states with few insurers, such as in Ohio's formerly insurer-free county.

What will the plans look like in 2018?  If the deductibles, premiums, and co-pays continue to rise as they have been doing since 2014, the plans will not be very attractive to many people. Many healthcare experts believe not all the metal tiers will be offered by insurers and the networks will be skimpy.

One can get an idea what premiums cost increases will be in 2018 by visiting CMS’s Rate Review website.  Simply choose a state you wish to review and an insurer’s name, or just leave the window blank to see what every insurer has requested.  For example, in Tennessee, the requested rate increases range from 2.5 to 48.8 percent.  In Nebraska, the requested rate increases range from 9.6 to 87.7 percent.

In Washington state, insurers requested an average 22.3 percent increase.  New York insurers requested an average 16.5 percent increase.  California insurers requested a 12.5 percent increase.   Many of the specific rate increases will not be approved but these numbers indicate that premiums are going up across the country by double-digits.

The bottom line is Obamacare’s problems are not over.  We will know more as we get closer to open enrollment, which begins November 1, 2017 and ends December 15, 2017.  That is why it is so important for Congressional Republicans to live up to their promise to repeal and replace Obamacare with policies that will encourage consumer driven healthcare.

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