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VOL. 131 | NO. 227 | Monday, November 14, 2016

Health Care Expert: '100 Percent Certainty' Things Will Change

By Andy Meek

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It’s way too soon to tell. That’s the message Group Benefits LLC has sent to clients in response to phone calls and messages that were pouring in after Donald Trump’s surprise win in the presidential election.


Callers wanted to know what it means for President Obama’s signature domestic legislative legacy, the Affordable Care Act.

It was already something of a tempestuous moment for the so-called Obamacare paradigm. Consumers in Tennessee were chafing at marketplace premium increases allowed by the Department of Commerce and Insurance and other realities like the pullout of BlueCross BlueShield Tennessee from individual marketplace plans for 2017.

Trump made attacking the ACA a centerpiece of his campaign. But even so, the team at Group Benefits says it’s just not clear yet what will change or when or how much will change or how quickly it will do so.

“Throughout his campaign, Trump vowed to repeal Obamacare and replace it with something absolutely much less expensive,” the Group Benefits email explained to clients. “The details of how, when or if this will occur are not yet known. There is a great deal of speculation swirling about executive orders, etc. However, it is going to take some time to get answers.”

In an interview, Group Benefits president and founder Tim Finnell was a bit more direct: having said all that, he explained, there’s nevertheless still a “100 percent certainty that things will change.”

He pointed to the new president issuing executive orders and cutting off funding for the legislation as one vehicle for making broad changes without going through the legislative complexity of deep-sixing it outright.

“First of all, repealing Obamacare needs 60 senators, and I’d say that isn’t going to happen,” Finnell said, referring the number of senators that comprise a filibuster-proof majority in the Senate. “It’s very unlikely. But you could do executive orders. President-to-be Trump could say we’re not going to fund subsidies. He has the power to do that.”

He then went on to draw a few more conclusions, based off an opinion he offers without understatement:

“If Hillary had been elected, this would have been a totally different conversation. We’d still have change, yes. But from a standpoint of expanding rather than contracting. To what degree, and how – there’s nothing to plan for right now.”

He doesn’t think key planks of the ACA will be scrapped wholesale, like children being able to stay on plans until age 26 or a rollback of no preexisting condition limitations. That’s because he thinks anything new that’s done is likely to start from where things are now, rather than first reverting back to 2009.

His point that change was inevitable anyway has particular resonance in Tennessee, where in September BlueCross BlueShield announced it’s dropping its Affordable Care Act marketplace plan coverage in three major regions of the state, including Memphis.

The health insurance provider pointed to losses of nearly $500 million on such plans by the end of 2016. In August, the Tennessee Department of Commerce and Insurance approved BlueCross’ request to raise rates on individual plans by 62 percent after BCBST told state leaders it lost $311 million on Individual/Marketplace plans in 2014 and 2015 and expected to lose another $100 million in 2016.

The issue, the company told the state, is that the pool of uninsured Tennesseans has too many sick individuals and not enough healthy ones whose premiums can offset costs.

United HealthCare, meanwhile, is also exiting the state exchange altogether in 2017. Commerce and Insurance Commissioner Julie McPeak in August also approved rate hikes for other insurers in the state – 46.3 percent for Cigna and 44.3 percent for Humana. Aetna, which doesn’t offer marketplace plans, was approved to raise premiums on its other individual plans by 14 percent.

The question for the moment, Finnell said, is whether health care legislation is going to change quickly or over time in a Trump administration. “And a lot, or a little. My guess would be a lot.”

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