The state’s largest Affordable Care Act insurer Florida Blue plans to return in 2018, but warned rates could jump 20 percent higher than expected if the Trump administration and Congress end payments designed to bring down costs for more than 1 million Floridians.
Florida’s Democratic congressional delegation told President Trump in a letter he is responsible if his “deliberate sabotage” destabilizes the market and makes care more expensive or harder to get.
Trump’s health secretary Tom Price on Monday characterized the real problem as “fewer Americans can afford to pay more and get less for healthcare,” noting not all who signed up for 2017 are paying their premiums.
Marketplace leader Florida Blue says it will be back in the state’s ACA marketplace in 2018, but company officials said premiums could be 20 higher than they otherwise would be if federal “cost-sharing” help for consumers to cover co-pays and deductibles is discontinued.
Trump has cast doubt on continuing such subsidies by calling them insurer “bailouts,” though they have been part of the ACA since its inception and Florida Democrats said they are an obligation under current law. They are estimated to be about $10 billion in 2018.
The Senate is now considering a major health overhaul that the House passed.
The House bill would wipe out ACA subsidies and close to $1 trillion in taxes on high earners and corporations. It would replace them with limited tax credits that could make lower-income, older people and those with pre-existing conditions pay more but potentially bring down costs for younger, healthier and higher-income people. About 23 million fewer people would be covered in 10 years compared with leaving Obamacare in place, the Congressional Budget Office said.
Florida Blue spokesman Paul Kluding declined to discuss the specific rate proposal that will be filed by June 21, but said “it is important to note that our rate filing assumes that cost-sharing reductions will be in place for 2018. Without CSRs, we estimate that, on average across the state, our rates would be an additional 20 percent higher than our originally submitted rates.”
Insurers face a June 21 deadline to file rates for 2018 markets.
If cost-sharing payments end, Trump will be responsible for “the destabilization of the marketplace and the deliberate sabotage of our neighbors’ health and financial well-being,” Florida’s Democratic delegation told the president in a June 8 letter. Signing members included U.S. Rep. Lois Frankel, D-West Palm Beach, and Rep. Ted Deutch, D-Boca Raton.
Trump’s Health and Human Services department said Monday that new numbers show declining enrollment in Affordable Care Act markets.
After taking office, the new administration slowed or stopped efforts to promote sign-ups, and GOP leaders crafting legislation signaled their intention not to enforce a penalty for failing to buy insurance.
The HHS report showed that 12.2 million individuals selected a plan at the end of open enrollment, and 10.3 million followed through to pay the premiums necessary to maintain coverage as of March 15, 2017.
“Consumers are sending a clear message that cost and affordability are major factors in their decision to cancel or terminate coverage,” said CMS Administrator Seema Verma in a statement.
In Florida, more than 1.4 million enrolled and more than 1.3 million in the marketplace paid premiums by March, with 93 percent of these getting premiums subsidies and 75 percent qualifying for cost-sharing reductions, the report said.
Ironically, ending the cost-sharing payments has been estimated to increase overall costs to taxpayers by $2.3 billion, because other subsidies designed to lower premiums would go up.
Making headline rates go up would most hurt the fewer than one in 10 Florida customers who make too much money to qualify for subsidies on marketplace plans.
The way the law works, monthly premiums for more than nine of 10 Florida customers probably will barely budge, staying near $84 a month on average, but those without subsidy help will bear the full brunt of rate increases that could top 20 percent.
“One popular Republican talking point is the so-called ‘implosion’ of the Healthcare.gov marketplace,” the Florida Democrats’ letter to Trump said. Florida has led states using the federal exchanges with as many as 1.7 million enrolled in recent years, the letter said, so “it is clear that the marketplace is not ‘imploding,’ but could be crushed from the outside if you continue the assault on the ACA and pull the rug out from under our neighbors.”