Consumer options as drama fades

Associated Press

As the political drama over health care legislation in Washington fades, the rest of the country faces a more immediate concern: Getting insurance for next year.

The Republican health plan designed to replace the Obama-era health law known as the Affordable Care Act would not have taken full effect for a few years anyway – and now it’s dead.

That means millions of Americans will have to navigate a current federal health care system that, while not “imploding” as President Donald J. Trump has said, is at least in flux.

Prices for insurance plans offered on the public insurance exchanges set up by the health care law have soared in many markets, and choices for customers have dwindled.

That’s because insurers have faced sizable financial losses on the exchanges in recent years and have responded by either hiking prices or pulling out of certain markets altogether.

Now, attention will turn to administrative changes underway in Washington designed to stabilize the exchanges by preventing more insurer defections.

WILL I HAVE PLANS TO CHOOSE FROM?

It depends on where you live. Choices are dwindling, but chances are at least one insurer will sell in your market. That company may offer several plans.

Generally, big cities will have more choices than rural areas where there may not be enough customers to attract insurers.

As of now, there are 16 counties in a region of Tennessee around Knoxville that have no insurers committed to sell coverage on the exchange next year. About a third of the nation’s 3,100 counties are down to just one insurer.

Insurers have been pulling back, and more are expected to leave, but health care researchers are not predicting mass defections.

FIXES IN STORE?

Last month, the Health and Human Services Department, which runs exchanges in many states, proposed some adjustments to try to stabilize these marketplaces.

For example, insurers want greater scrutiny of people who sign up for coverage outside of the open- enrollment period.

Another proposed adjustment would let insurers design cheaper plans tailored to younger people who may not need lots of health care but want to be protected in the event of a big injury or sickness.

DECISIONS ON 2018?

Some have said they want to see the final version of the proposed federal adjustments before deciding where and what kinds of coverage they will offer.

But insurers generally have to decide by this spring whether they will participate in order to leave enough time for regulatory approvals and marketing before enrollment starts next fall.