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Collapse? Six insurers eye return to Florida’s 2018 Obamacare market

Senate Majority Leader Mitch McConnell said Obamacare is “on the edge of collapse” after unveiling a new health plan Thursday, but six companies gave notice they want to return to Florida’s Affordable Care Act individual marketplace in 2018, state officials said.

A total of nine insurers filed rates for individual plans compliant with the health law, on or off the exchange, according to the Florida Office of Insurance Regulation.

The average requested rate increase for the nine companies is 17.8 percent, slightly below last year’s approved average hike of 19.1 percent. For the six companies on the exchange, it’s 17.3 percent, officials said.

But most customers don’t pay anywhere near that under the health law.

Instead, about nine in 10 of Florida’s approximately 1.5 million marketplace customers saw their monthly premiums barely change at all from an average of about $84 because of government subsidies that lower what they actually pay. Customers who make too much money to qualify for government aid face the full impact of the rate increases.

The subsidies face big changes or elimination under GOP plans including the Senate proposal.

Many companies have claimed trade secrecy for what they propose to charge in 2018. Florida Blue, also known as Blue Cross & Blue Shield of Florida, declined to discuss details of its filing Thursday.

But company officials warned earlier this month premiums could jump an additional 20 percent if the Trump administration and Congress end “cost-sharing” payments designed to bring down costs for more than 1 million Floridians.

Others returning to the Obamacare exchange in 2018 include Celtic Insurance Co., Florida Health Care Plan Inc., Health First Commercial Plans Inc., Health Options Inc. and Molina Healthcare of Florida Inc.

Fourteen companies submitted filings for the state’s small group market with an average requested increase of 9.2 percent in 2018.

President Donald Trump has thrown a cloud of uncertainty over continuing cost-sharing subsidies by calling them insurer “bailouts,” though they have been part of the Obamacare marketplace since its inception. They are estimated to total about $10 billion in 2018.

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.

The Senate plan would continue cost-sharing payments through 2019, then start offering less generous subsidies in 2020.

A year ago, Florida regulators approved an average increase of 19.1 percent for 14 insurers, including seven who operated both on and off the ACA exchange. The others were off-exchange only.

Last year, Florida Blue was granted a 19 percent increase, more than its initial request of 14.5 percent. Regulators said they granted higher premiums for some companies after conditions changed since the original filing.

In 2016, Florida health insurance premiums rose less than 10 percent.

McConnell said Thursday the Senate plan will “free Americans” from Obamacare’s taxes and mandates while offering greater help to low-income people than the House bill does, but it faced immediate criticism from Democrats and at least four Republican conservative senators whose support it needs to pass.

The plan largely keeps the basic structure of the House bill by eliminating about $1 trillion in taxes along with the requirement consumers must buy insurance or pay a penalty. It delays the rollback of Medicaid expansion but imposes long-term cuts to that program that opponents characterized as ultimately more harsh than the House version.

“Now we know why they tried to keep this secret,” said Florida’s Democratic Sen. Bill Nelson. “This bill is just as bad as the House bill, taking coverage away from millions of people and making huge cuts to Medicaid. If that weren’t enough, it also allows insurance companies to hike rates for older Americans.”

Like the House bill, the Senate plan lets insurers charge people 50 to 64 five times what they charge younger people, up from three times under current law.

“This new Senate bill was crafted in secrecy behind closed doors without a single hearing or open debate — and it shows,” said AARP Executive Vice President Nancy LeaMond. The plan “would hit millions of Americans with higher costs and result in less coverage for them. AARP is adamantly opposed to the age tax, which would allow insurance companies to charge older Americans five times more for coverage than everyone else while reducing tax credits that help make insurance more affordable.”

Florida’s Republican Sen. Marco Rubio “will decide how to vote on health care on the basis of how it impacts Florida” after consulting with state leaders, his office said.

Compared with the House bill, the Senate bill makes a greater effort to help low-income people pay for insurance premiums, but at a reduced level compared with the Affordable Care Act. Subsidies would go to those making 350 percent of the poverty level, compared to the ACA’s 400 percent eligibility now. The House bill, meanwhile, replaces ACA subsidies with tax credits tied to age.

The Senate version risks displeasing both consumers facing reduced government help and also critics on the right that the bill preserves too much of Obamacare. At least four GOP senators — Rand Paul of Kentucky, Ted Cruz of Texas, Ron Johnson of Wisconsin and Mike Lee of Utah — said they cannot support the bill, jeopardizing its chances for passage, though they would be open to negotiation.

Conservative think tanks frowned. FreedomWorks President Adam Brandon said, “Unfortunately, the Senate bill is an amendment to Obamacare, not a repeal of it.”

The Senate bill winds down Medicaid expansion more slowly but opponents say it imposes more stringent long-term caps on spending than the House does.

Medicaid covers 4 million people in Florida, including about half the childbirths and 70 percent of seniors in nursing homes and 41 percent of Palm Beach County’s children.

The bill appears to provide consideration for those with pre-existing conditions, though advocacy group Consumers Union warned it opens the door to put annual and lifetime caps on benefits, which it said puts many people at risk. The group called the overall plan “harsh and misguided.”

There is talk of a vote as early as next week after a Congressional Budget Office score is available.

For more, visit My Palm Beach Post.

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