The Senate Committee on Health, Education, Labor, and Pensions kicked off their hearings on stabilizing the individual health insurance market yesterday. These bipartisan discussions aim at strengthening our healthcare system for American families, or nearly 18 Million consumers. The first of four hearings, committee members heard from 5 insurance commissioners: Julie Mix McPeak (Tennessee), Mike Kreidler (Washington),  Lori Wing-Heier of Alaska, Teresa Miller (Pennsylvania), John Doak (Oklahoma):

Julie Mix McPeak’s testimony honed in on the Tennessee insurance market’s near collapse for 2016 and 2017.  Emphasizing the 75 of 98 counties where consumers will have a single insurance carrier to select coverage from on the individual market, her testimony called attention to the insurers that have exited the market following their substantial losses; in 2010 there were a dozen carriers, now there are only 3 carriers in the state with ACA compliant options. In closing, McPeak recommended that the Federal government should develop a defense mechanism, with stop losses, reinsurance programs, and CSRs, to address the issues of affordability and accessibility. In doing so, she cited how this “…will help us get back to a vibrant market.”

“You must take bold actions to shore up these markets,” stated Mike Kreidler who echoed similar concerns while informing the committee of the “pull backs” observed this year. This includes the 2 counties that were “bare” prior to Premera Blue Cross announcing it would offer coverage in Grays Harbor County, and both Molina Healthcare of Washington (Molina) and BridgeSpan Health Company (BridgeSpan) in Klickitat County. There are also 9 rural counties that will have a sole insurer offering coverage this year. He advised that the next two weeks will be very telling, recommending that “congress move quickly” to resolve the insurance market which is in “serious peril.” Upon his recommendations were: reinsurance programs, which have been proven successful in Washington, 1332 Waivers, guardrails, and the preservation of consumer protections, including the 10 essential health benefits (EHB).

Lori Wing-Heier of Alaska offered an insight into the states across the nation could benefit from ACA waivers. As one of the two states with an approved 1332 waiver, Wing-Heier highlighted her state’s proven success in providing stability and reducing high premiums with its reinsurance program. Despite this, she advocated that more must be done to provide aid to the insurance market. Her suggestions: introduce more collaborative reforms that promote affordability and accessibility, introduce reinsurance programs that increase enrollment, attract healthier consumers, and help to reduce premiums, which rose 203% in Alaska since 2013.

Many Pennsylvanians have benefited from the Affordable Care Act (ACA), explained Secretary Teresa Miller, who shared how more than 426,000 consumers receive coverage through the individual market. Despite this, she explained how her state’s market is experiencing difficulties, but is far from collapsing. There are many options to resolving this, Miller hinted. This includes continuing CSR payments and establishing a more robust risk pool, in order to support a competitive market that ensures consumers have access to affordable, quality care. In closing, she stressed that as a nation, we need to have a serious conversation regarding healthcare costs, citing that “this is a national issue.”

In 2018, Oklahomans will have only one insurance carrier.  Having undergone “serious market disruptions” as result of fleeing insurers due to substantial losses and deductible shock, John Doak explained how recent efforts have failed in the state. To remedy this, he talked about the driver behind Oklahoma’s decision to apply for a 1332 waiver, and encouraged the Senate Committee to observe the need for state affordability and flexibility.

According to Senator Lamar Alexander (R-Tenn), the Committee is looking to reach a balanced stabilization bill by the end of September. In doing so, they aim to avoid interruptions with the plans and rates available for the 2018 Open Enrollment Period.  There are three more hearings scheduled; Governors on September 7, Advocates for State Flexibility on September 12, and Health Care Stakeholders on September 14. Each will be available for public viewing via a live feed.

The views and opinions expressed by the authors on this blog website and those providing comments are theirs alone, and do not reflect the opinions of Softheon, Inc. or any employee thereof.

Yvonne Villante
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Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
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