{"id":1490,"date":"2018-02-14T08:20:44","date_gmt":"2018-02-14T13:20:44","guid":{"rendered":"http:\/\/haiti-observateur.ca\/?p=1490"},"modified":"2018-02-14T08:20:44","modified_gmt":"2018-02-14T13:20:44","slug":"congress-must-stabilize-the-individual-market","status":"publish","type":"post","link":"https:\/\/haiti-observateur.ca\/?p=1490","title":{"rendered":"Congress must stabilize the individual market"},"content":{"rendered":"

S<\/strong>enators Lamar Alexander\u00a0(R-TN) and Patty Murray (D- WA) created a bipartisan bill\u00a0last year to improve health insurance markets. The deal allocates funds for cost-sharing\u00a0reductions, which reduce out- of-pocket costs for low-income beneficiaries.<\/p>\n

The senators\u2019 bill is a welcome step to stabilizing the\u00a0individual markets. The Administration previously announced its intention to slash\u00a0funds for CSRs. That action, though, would skyrocket premiums for low-income beneficiaries and price some out of\u00a0 coverage, further eroding the\u00a0individual market.<\/p>\n

Continuing CSR payments is a critical step. But\u00a0our country needs more legislative action to reform the\u00a0individual insurance markets. Without it, premiums will\u00a0continue to soar and Americans will have fewer options\u00a0for coverage.<\/p>\n

One of the reasons the\u00a0individual market is unstable\u00a0is because it lacks enough\u00a0young, healthy enrollees pay- ing premiums to offset the\u00a0costs of older, sicker enrollees. Millennials must comprise 40 percent of the market\u00a0pool if rates are to be stable. But only 28 percent of enrol lees are 34 or younger.<\/p>\n

Consequently, health insurers have struggled. Anthem lost $374 million selling\u00a0such policies in 2016. Many insurers are responding by reducing or eliminating agent commissions or\u00a0pulling out of the individual\u00a0market. Nearly 40 percent of\u00a0those that sold plans in 2017\u00a0won\u2019t do so this year.<\/p>\n

The insurers that are stick ing around have raised premiums \u2014 in 2017, by an aver- age of 25 percent. In 2018, premiums could increase\u00a0even more.<\/p>\n

This is unsustainable. Hikes discourage healthy people\u00a0from enrolling. Insurers\u00a0would have to boost premiums further to cover their\u00a0costs. That would cause even\u00a0more healthy people to drop\u00a0coverage. Eventually, the\u00a0individual market will collapse.
\nCongress could lower premiums by eliminating the\u00a0Health Insurance Tax (HIT).<\/p>\n

This sales tax on health plans\u00a0is expected to increase premiums by $158 for individual\u00a0plans and $188 for large\u00a0group insurance in 2018.<\/p>\n

Congress suspended HIT\u00a0for one year in 2017. Law-makers would be wise to\u00a0eliminate it completely. Lower premiums would\u00a0make plans attractive for\u00a0young, healthy Americans. The more people in the individual market, the easier it is\u00a0for insurers to project overall\u00a0costs \u2014 and avoid the need\u00a0for massive rate hikes.<\/p>\n

Congress could also give\u00a0states more funding to enact\u00a0their own reforms. For instance, Alaska previously implemented a $55 million \u201creinsurance\u201d program for\u00a0high-cost enrollees. Essentially, the state helped pay\u00a0claims for extremely sick\u00a0enrollees. That reduced the\u00a0financial burden on insurers
\nand enabled them to lower\u00a0premiums by 24 percent. Congress should also es- tablish safeguards to promote\u00a0positive outcomes and main- tain a functioning employer- based coverage system.<\/p>\n

Regulatory changes could\u00a0stabilize the individual market, too. The administration\u00a0can start by easing the enroll- ment process. In 2016, three\u00a0in four people shopping for an\u00a0individual plan who received\u00a0 assistance from people like\u00a0insurance agents or brokers\u00a0enrolled in plans.<\/p>\n

In addition, cracking down\u00a0on the abuse of \u201cspecial\u00a0enrollment periods\u201d would\u00a0enable insurers to better pre- dict claims costs \u2014 and\u00a0reduce the need for premium\u00a0hikes.<\/p>\n

Most people buy coverage\u00a0during open enrollment. But if\u00a0people experience certain life\u00a0events, they can sign up during a special enrollment period. In 2015, people who signed up during special enroll- ment cost 41 percent more to\u00a0insure than regular enrollees.<\/p>\n

To prevent fraud, regulators could require people to\u00a0prove that they\u2019re eligible for\u00a0special enrollment.<\/p>\n

The individual market is\u00a0not sustainable. Lawmakers\u00a0need to protect the millions of\u00a0Americans who are faced\u00a0with rising premiums, fewer\u00a0choices, and uncertainty due\u00a0to the instability of the individual market.<\/p>\n