doctors exam room
Allergy tests cost. Published on Flickr by Parker Knight, Creative Commons attribution license

“As health insurers across the country begin filing their proposed rates for 2019, one thing is clear: The market created by the Affordable Care Act shows no signs of imminent collapse in spite of the continuing threats by Republicans to destroy it,” Reed Abelson writes over at The New York Times. “In fact, while President Trump may insist that the law has been ‘essentially gutted,’ the A.C.A. market appears to be more robust than ever, according to insurance executives and analysts. A few states are likely to see a steep spike in prices next year, but many are reporting much more modest increases. Insurers don’t appear to be abandoning markets altogether. In contrast to last year, regulators are not grappling with the prospect of so-called ‘bare’ counties, where no carrier is willing to sell A.C.A. policies in a given area. ‘The market is in a better position now than it has ever been since the exchanges have opened,’ said Deep Banerjee, who follows insurers for S & P Global Ratings. The companies first began selling policies in the state exchanges, or marketplaces, five years ago. After years of losses, the insurers are now generally making money. With roughly a third of states releasing information, the insurers’ rate requests vary widely, according to an analysis by the Kaiser Family Foundation. In Maryland, companies are seeking increases averaging 30 percent. A midlevel policy in Baltimore could cost $622 a month, roughly a third higher than the average of the other states reporting to date.   In Minnesota, which created a reinsurance program to help pay for customers’ expensive medical conditions, carriers are actually seeking lower premiums. A midlevel policy in Minneapolis is priced at $302 a month. The political and legal turmoil in the market is likely to persist, and final premiums will not be established for months. States are still working out details of some of their proposals to stabilize their own marketplaces. Those could be blocked by the federal government or a federal court, as in the case of last Friday’s decision regarding the work requirement sought by Kentucky for its Medicaid program. ‘We will start seeing more variation in the coming years, not just in premiums, but what rules the states are enforcing,’ said Cynthia Cox, a policy expert at the Kaiser foundation. Insurers are also watching the developments in the Texas lawsuit brought by Republican attorneys general. The Justice Department recently sided with the Republican states in arguing that the provisions protecting people with existing medical conditions are unconstitutional, which would upend the market entirely.” Reed Abelson, “Obamacare Is Proving Hard to Kill,” The New York Times.

Jeanne Pinder

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...