Faced with sicker than expected enrollees, insurers pulled back from the market and hiked premiums. It would also halve the open enrollment period for 2018, cutting it down down from the previously standard November 1 - January 31 to end on December 15 instead. Some 14 million people have gained coverage through the expansion of Medicaid to people who earn up to 138 percent of the federal poverty limit, or $16,000 a year for a single adult.
Based on its initial analysis of data associated with the company's healthcare exchange membership following the 2017 open enrollment period, Humana is seeing further signs of an unbalanced risk pool.
Trump himself clearly agreed, tweeting, "Obamacare continues to fail". "So we withdrew to markets that allowed us to manage the risk we had in only four markets and we're going to lose a lot of money in those markets this year".
The rule also addresses insurers' complaints about potential abuse of special enrollment periods in the individual market, requiring people to submit documents proving they qualify for changes to their coverage. The agency now proposes to expand that to 100%. "What happens is the people who are paying out of pocket for most of it leave because it is becoming too expensive", he said. Insurers have always been pushing to loosen up that requirement and allow for charging older people more. The issuer would have to apply this policy to all employers or individuals regardless of health status. This change is a result of Trump's executive order to reduce the regulatory burden of the law when possible and is a return to the policy that was in place for 2015 taxes, the IRS said.
Health insurers, though, are businesses.
Register says it can take as many as 10 years to establish a successful treatment plan for people in need of mental-health care, and a disruption of treatment can instigate behavior that would make it impossible for them to function in society. Insurers will no longer have to assess whether they have a network that has an adequate number and variety of providers.
The proposed rule gives states greater authority, CMS said.
"The overall effect of numerous policies here would actually, over time, I think, actually shrink enrollment, not grow enrollment", says Sabrina Corlette a research professor at Georgetown University's Center on Health Insurance Reforms. Asked if Aetna was pulling out, he replied, "We have not yet made that decision". Overall, countries with universal health insurance fare better in both expense and population health outcomes, though there are many complicated variables.