Tavenner asks Congress to save 2018 individual health market

The AHIP head says insurers need clear signals by March to avoid massive disruption

Marilyn Tavenner called to the continuation of the ACA reinsurance and subsidy programs critical to market stability. (Photo: Senate HELP Committee) Marilyn Tavenner called to the continuation of the ACA reinsurance and subsidy programs critical to market stability. (Photo: Senate HELP Committee)

Insurers need to have a clear sign of how the individual major market will really work in 2018 by March, or coverage could disappear in many markets throughout the United States.

Marilyn Tavenner, president of Washington-based America's Health Insurance Plans, gave that warning Wednesday at a hearing that was organized by the Senate Health, Education, Labor and Pensions Committee.

"We need to understand what's going to happen," Tavenner said at the hearing, which was held in Washington and streamed live on the web. "We need some signals of stability."

Related: Anthem considering big 2018 individual market changes

Tavenner told Sen. Lamar Alexander, R-Tenn., the committee chairman, that, at a minimum, insurers need to see that the federal government will continue the Affordable Care Act premium tax credit program, the ACA cost-sharing reduction subsidy program and the ACA reinsurance program. She added that the government should give insurers at least about 18 months to adapt to any major new rule and program changes.

In many states, the current rules call for insurers to file information about their 2018 individual plans by May, and their rates by July, according to Tavenner and other hearing witnesses. Witnesses said insurers need to make decisions about what they will offer in 2018 by March to have product filings ready by May.

Alexander noted that Republicans in Congress might not be happy about continuing ACA subsidy programs while they are trying to change or replace the ACA, and he asked Tavenner how important the programs are.

"I think they are critical," Tavenner said. "They are required."

If the programs go away, many more carriers will withdraw from the individual market, many communities will have no individual health insurance products, and the upheaval will add an extra 20 percentage points to the rate increases the insurers would have to impose to reflect changes in the underlying medical cost trend, Tavenner said. 

Related:

Aetna to stay out of individual health market in 2018

ACA change rules

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