AHIP says efforts to maximize, or not maximize, enrollment "send strong signals" for 2018. (Image: CMS)

The Trump administration’s decision to halt advertising for HealthCare.gov Thursday may increase pressure on insurers to withdraw from the U.S. individual major medical market, or sharply reduce participation, in 2018.

Related: Trump administration pulls some ACA ads as deadline nears

Open enrollment for 2017 started Nov. 1 and is set to end Jan. 31. Insurers and Affordable Care Act exchange managers have mostly operated under the assumption that the administration would let the exchange system continue normal operations this year, and possibly during a transitional period next year.

Paul Demko of Politico reported Thursday that the administration is withdrawing about $5 million in ads that were supposed to tell consumers about the end of the open enrollment period.

Kristine Grow, a senior vice president at America’s Health Insurance Plans, sent out a statement from the Washington-based group with the introduction, “I wanted to be sure you had our statement on the matter.”

Maximizing participation in the individual health insurance market is one good way to cut enrollees’ costs, AHIP said in the statement.

“Balancing out the risk pool is an important action that can be taken now to help stabilize the market, improve affordability, and send strong signals as health plans develop their products for 2018,” AHIP said.

The reference to “strong signals” appears to be a sign that health insurers are out of patience with uncertainty about federal involvement in the individual health insurance market, and sudden federal government policy changes that hurt health insurers.

Uncertainty lingers

Obama administration ACA program managers hurt insurers with many sudden, last-minute moves to push back deadlines, loosen enrollment rules for new coverage, and let consumers keep coverage written under the old, pre-ACA rules.

Republicans in Congress hurt insurers with moves to cut billions of dollars in ACA program funding.

Related: Feds to insurers: No 2015 ACA risk corridors money for you

Anne Filipic, president of Enroll America, a nonprofit, Washington-based ACA public exchange enrollment support group, put out a statement of her own calling the HealthCare.gov advertising support cancellation outrageous.

The consumers enrolling in exchange plan coverage “don’t care about political infighting in Washington, and unless and until an alternative system is in place, they deserve to have every possible resource available to help them make sure they and their families are covered,” she said in a statement.

The Obama administration set up HealthCare.gov to handle ACA exchange enrollment and account administration in states that were unable or unwilling to handle the job themselves. The Centers for Medicare & Medicaid Services, an arm of the U.S. Department of Health and Human Services, has been conducting health plan rate reviews, under ACA rate review rules, in many HealthCare.gov states.

Originally, the Trump administration and Congress said they would have a proposal for repealing the ACA, or at least de-funding it, by today.

Republicans in Congress now are suggesting they might not be able to agree on a plan for changing the ACA regulatory system until August.

Current ACA system rules call for insurers in the states in which HHS handles rate reviews to file 2018 individual market products forms and initial rate proposals, for both on-exchange and off-exchange products, from April 5 through May 3. Insurers are supposed to have 2018 rates ready to go up on a public website by Aug. 1.

If the Trump administration and Congress take more than a few weeks to tell insurers what the ACA exchange system market rules and the off-exchange market rules will look like in 2018, insurers may have trouble participating, even if federal and state regulators ease the current product and rate filing schedule.

Related:

Obama administration adjusts ACA exchange program for 2018

Meet the woman tasked with selling the ACA

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