Health & Spirit

As Trump attacks the federal health law, some states try to shore it up

Christine Vestal, on

Published in Health & Fitness

"Consumers are still confused about health insurance subsidies, and they're hearing a lot of bad news about the ACA," said Sarah Lueck, an insurance analyst at the left-leaning Center on Budget and Policy Priorities. "States need to tell consumers that the market isn't crumbling, because it's not. There are still some really good deals out there."

It's too early to know how many other states will move this year to fill the policy gaps in the tattered Affordable Care Act. But consumer advocates are urging lawmakers and governors to act sooner rather than later.

"States need to prepare now if their initiatives are going to have the desired effect," Lueck said. If states want to stabilize the insurance industry by establishing individual mandates or reinsurance programs, they need to have their policies in place before spring and summer, when companies are required to file preliminary rates for 2019, she said.

For states that want to follow New Jersey's lead and beef up outreach and marketing for their insurance exchanges this year, there's a little more time. Insurance exchange marketing typically doesn't start until September, two months prior to open enrollment in November.

But there's another approach states can take at any time to protect their traditional insurance markets from the continued uncertainty created by attacks on the ACA from Congress and the Trump administration.

Once federal agencies finalize rules allowing cheaper, substandard health policies, states can prohibit those policies from being sold within their borders unless they comply with ACA consumer protections, according to a recent article by a group of consumer advocates in the policy journal Health Affairs.

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New Jersey and New York already have such prohibitions, and Minnesota allows non-complying health plans to be sold only under limited circumstances.

Before the Affordable Care Act took effect in 2014, people who were self-employed, between jobs or working part time and were not offered employer-sponsored health plans typically had to pay the highest prices for health coverage because insurers considered the relatively small pool of individuals riskier than larger groups.

Many people who faced high-priced individual insurance policies took their chances and went without coverage. Others opted for cheaper plans with high out-of-pocket expenses and limited benefits.

For this group, the ACA's consumer protections were a huge boon. Confident they could find affordable health insurance, many workers were able to strike out on their own for the first time.


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