Insurers Step Up Lobbying With an Eye to Health-Law Changes


Health insurers are bracing for rapid changes to the Affordable Care Act, preparing contingency plans for their business and readying a full-court lobbying press as Congress looks to overturn swaths of the law[1] as soon as January.

Republican leaders in the House and Senate have promised quick action on the health law. They have said that much of the dismantling—and replacement—could take effect after a transition period of as long as a few years. However, certain moves could affect the ACA’s health-plan marketplaces far sooner, including any early decision to scrap enforcement of the individual mandate, which requires most Americans to have health insurance.

That has set off a frantic lobbying effort by insurers and other health-industry groups to warn that if Congress and the Trump administration aren’t careful, they risk shredding the individual insurance market as soon as 2018. The ACA health-insurance marketplaces were already unstable in many places, with some insurers pulling out amid financial losses and others threatening to do so in 2018 even before the Republicans won the White House.

If the wrong steps are taken, “we could see a situation where no carrier would want to offer insurance” in the individual market, said

Mario Molina,

chief executive of

Molina Healthcare[2] Inc.,

which offers ACA exchange plans in nine states as well as Medicaid coverage.

Part of the challenge is the nature of the health-insurance industry, which is built around advance planning and detailed projections of risk. Insurers must make filings this spring if they intend to offer ACA plans in 2018. They are already largely locked in for 2017 plans, though under certain circumstances they could withdraw from ACA exchanges partway through a plan year, legal experts said.

“We need to know what the ground rules are so we can make decisions” for 2018, said Alan Murray, chief executive of CareConnect, the insurance unit of New York’s Northwell Health.

Jeff Smedsrud, co-founder of the online insurance brokerage, said he has told legislators and their staff to consider changes in early 2017 including creating a new compensation mechanism for insurers with especially large claims from individual enrollees. He said this could help prevent a meltdown in 2017 and 2018. He is also calling for tax filers to be allowed to deduct all health-insurance premiums and out-of-pocket medical expenses in excess of $1,000 from their federal returns, a move that could boost the individual market, and also his site.

Absent clearer signposts for now, insurers are preparing for a range of possibilities. “We’re doing some scenario-planning,” said

Joan Budden,

chief executive of Priority Health, an insurer in Michigan.

Among the possibilities that most concern insurers are an abrupt removal of the penalties for not having insurance coverage, or a halt to the federal subsidies that help lower-income Americans buy plans. Without other moves that would compensate for those changes, insurers fear losing healthy customers who balance out the sicker people, who are more likely to keep coverage even without a mandate.

“We’d have a difficult time staying in the marketplace with the elimination of subsidies or the elimination of the individual mandate,” said

Kirk Zimmer,

executive vice president at Sanford Health Plan, which sells ACA policies in North and South Dakota. Sanford would also be affected if the ACA’s Medicaid expansion were dialed back.

Insurers are also closely watching the fate of a legal case originally filed by the Republican leaders of the House. A judge found that the Obama administration overstepped[3] in helping to pay the health costs of some low-income ACA enrollees. If that ruling took effect, health insurers could lose this cost-sharing funding. For now, that case is on hold at the request of congressional Republicans. But once it takes office, the Trump administration could drop the Obama administration’s appeal of the ruling.

America’s Health Insurance Plans, an industry group representing a variety of carriers, has said it advocates maintaining funding for programs designed to mitigate insurers’ losses from high-cost enrollees, and opposes immediate axing of the health-cost subsidies. The group has also said it wants to see the health law shored up for the duration of its existence through tighter restrictions on who can sign up outside of the normal enrollment period, and curbs on programs that help pay ACA-plan premiums for sick people eligible for government health programs—two factors that insurers have cited as reasons they have incurred large claims.

Write to Anna Wilde Mathews at and Louise Radnofsky at[4][5]

Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8


  1. ^ overturn swaths of the law (
  2. ^ Molina Healthcare (
  3. ^ Obama administration overstepped (
  4. ^ (
  5. ^ (

Source URL: Read More
The public content above was dynamically discovered – by graded relevancy to this site’s keyword domain name. Such discovery was by systematic attempts to filter for “Creative Commons“ re-use licensing and/or by Press Release distributions. “Source URL” states the content’s owner and/or publisher. When possible, this site references the content above to generate its value-add, the dynamic sentimental analysis below, which allows us to research global sentiments across a multitude of topics related to this site’s specific keyword domain name. Additionally, when possible, this site references the content above to provide on-demand (multilingual) translations and/or to power its “Read Article to Me” feature, which reads the content aloud to visitors. Where applicable, this site also auto-generates a “References” section, which appends the content above by listing all mentioned links. Views expressed in the content above are solely those of the author(s). We do not endorse, offer to sell, promote, recommend, or, otherwise, make any statement about the content above. We reference the content above for your “reading” entertainment purposes only. Review “DMCA & Terms”, at the bottom of this site, for terms of your access and use as well as for applicable DMCA take-down request.

Acquire this Domain
You can acquire this site’s domain name! We have nurtured its online marketing value by systematically curating this site by the domain’s relevant keywords. Explore our content network – you can advertise on each or rent vs. buy the domain. | Skype: TLDtraders | +1 (475) BUY-NAME (289 – 6263). Thousands search by this site’s exact keyword domain name! Most are sent here because search engines often love the keyword. This domain can be your 24/7 lead generator! If you own it, you could capture a large amount of online traffic for your niche. Stop wasting money on ads. Instead, buy this domain to gain a long-term marketing asset. If you can’t afford to buy then you can rent the domain.

About Us
We are Internet Investors, Developers, and Incubators- operating a content network of several thousand sites while federating 20+ eCommerce and SaaS startups. With our proprietary “inverted incubation” model, we leverage a portfolio of $15M+ in valued domains to impact online trends, traffic, and transactions. We use robotic process automation, machine learning, and other proprietary approaches to power our content network. Discover our work!