Insurers are grappling with a serious predicament in finalizing how much their health plans will cost, even after a three-week extension from the Trump administration.
The new Sept. 5 deadline gives carriers more time to tweak their premiums for HealthCare.gov in a year where uncertainty surrounding the law has reached a new high.
But even as the Trump administration gave insurers more time, it failed to answer the central question insurers are asking: namely, whether they will continue to receive key payments from the federal government.
“It’s helpful, yes,” Jon Godfread, North Dakota’s insurance commissioner, said Friday of the delay. “But at the same time, it’s an answer to a question we’re not asking right now. We’re asking are [cost-sharing reduction payments] going to be funded; are they not? Give us a definitive answer, and we still don’t have that.”
No one knows how the Trump administration will manage ObamaCare, which makes it exceedingly difficult for insurers to price their plans. Unless they receive answers soon, sources said, insurers would be in the same position come Sept. 5.
Carriers have been pleading for certainty that the federal government will continue cost-sharing reduction payments (CSRs), which compensate insurers for subsidizing the out-of-pocket costs of certain enrollees.
“They can keep pushing this back as long as they want,” Chris Sloan, a senior manager with the consulting firm Avalere Health, said. “But until health plans know whether CSRs are going to be available in 2018 or not, they can’t have confidence that they’re pricing their products correctly.”
In a memo on Thursday, the Centers for Medicare and Medicaid Services (CMS) detailed changes to the risk adjustment methodology and changes to the deadlines for insurers. According to a CMS spokesperson, the agency is providing clarity and more time to account for recent rating practices at the behest of state insurance departments and issuers.
But the memo…