Insurance regulators are panicked about Obamacare’s future

The White House’s decision to stay mum on certain health policy issues — particularly whether it will fund key Obamacare payments for low-income enrollees — has left insurers skittish about selling marketplace coverage in 2018.

Health insurers say they can’t make decisions about participating in the health law marketplaces until the Trump administration makes its policies clearer. Does the White House really expect the marketplaces to explode, as President Trump has said previously, or are they planning to take action to make them work?

Regulators, meanwhile, worry that some areas in the country will end up with big rate hikes or no plans willing to sell Obamacare coverage at all.

“It’s been hard to know what is going to happen because the federal government doesn’t know what they’re going to do,” says Doug Ommen, Iowa’s insurance commissioner.

ever since the GOP health care bill failed — and the president predicted the marketplace’s failure — things have felt different.

“You had a couple of members of Congress talking about how they’ll wait for the marketplaces to collapse,” she says. “All of a sudden our insurers are like, “Oh, no. If you all want to make it fail, that can happen.”

There is an acronym you should get ready to hear a lot in coming weeks and months: CSR. It stands for cost-sharing reductions, which the federal government pays to health insurers to lower cost sharing (things like deductibles and copays, for example) for the poorest Obamacare enrollees. Last year, the federal government paid out $7 billion through this program.

The House filed a lawsuit in July 2014 arguing that Congress didn’t actually appropriate the money for those funds, and therefore the administration should not continue to make these payments. Nick Bagley wrote an excellent in-depth explainer on the lawsuit if you want to learn more.

Long story short: The Trump administration has to decide whether it will continue to defend these CSRs — or if it will concede to the House’s case (that the administration doesn’t have authority to make these payments) and end a multibillion-dollar Obamacare funding source.

(Excerpted from Vox 4/10/17)