Connecticut Officials Worry About Lack Of Clarity In Health Care Law | Connecticut Public Radio

Connecticut Officials Worry About Lack Of Clarity In Health Care Law

Apr 26, 2017

National uncertainty over the future of the Affordable Care Act is making state officials nervous, and the CEO of Access Health CT, the state’s health care exchange, has told his board that he fears insurers could back out of the marketplace the state created. 

Republicans in Congress are continuing their discussions over whether and how to repeal and replace Obamacare. There’s no way to know whether they’ll be successful. But ongoing efforts to chip away at the existing law are causing uncertainty here in Connecticut.

That was the message Jim Wadleigh, who runs Access Health CT, gave his board.

Wadleigh said that he has been informally told this by both of the remaining insurers on the private insurance marketplace: The uncertainty from Washington could force them to drop out of Obamacare altogether.

"Over the last five years, Connecticut has been seen as a leader in the rollout of the Affordable Care Act," Wadleigh said. "And I’m worried that we could be seen as the first marketplace not to have carriers in 2018."

Two items cause him specific concern.

First, there’s been talk of stopping federal payments for what’s known as cost sharing reductions -- those are payments from the government to insurers to help cover the costs of copays and deductibles for the poor.

Second, Wadleigh said that there could be more trouble if the Trump administration chooses not to enforce the mandate that all Americans must have insurance or pay a penalty.

"I expect that the lack of clarity around these two items will have a major impact on rate submissions," he said. "National discussions have each of these items potentially adding 10 to 20 percent to rates if they're not clarified down in Washington, D.C."

Wadleigh’s big picture point is that insurers are looking at least to break even on the Affordable Care Act.

These changes from the nation’s capital could make that nearly impossible -- and could, he fears, force the two remaining insurers out of the marketplace entirely.

They are Anthem and Connecticare.

Immediate efforts to reach them for comment were unsuccessful.