Senate Republicans failed to repeal and replace the Affordable Care Act, and a few GOP leaders have said they’re moving on to other priorities. But there’s still a lot of uncertainty about the future of the nation’s health care system. Reno Public Radio’s Anh Gray checks in with Director of Health Policy Research at the University of Nevada, Reno School of Medicine John Packham to break down how the ongoing tension in Washington is affecting our state.
Here in Nevada, two insurance companies have pulled out of the state’s health insurance marketplace. Their exit leaves 8,000 residents living in 14 counties—mainly rural ones—without health insurance.
John Packham is the Director of Health Policy Research at the University of Nevada, Reno School of Medicine.
“The problems that we are seeing with the availability of plans in rural areas are largely emanating right now with the noise coming out of Washington," Packham says.
Packham says political rhetoric is creating market instability. In tweets and statements, President Trump has threatened to withhold cost-sharing reductions (CSRs). CSRs are the federal subsidies that the government provides to insurance companies to cover low-and middle-income Americans.
There are also reports that the current administration is considering non-enforcement of an unpopular provision of the Affordable Care Act, the individual mandate, which requires people to obtain health insurance. Packham says this is one part of the legislation that is vital to market stability.
"These threats of withholding payments, these threats of not enforcing the individual mandate and employer mandates," Packham says, "are not helping matters.”
Packham says state officials are working on solutions that would help mitigate the fallout from the loss of health coverage for rural Nevadans.
“I think there are some options that states are going to have to wrestle with over the next year or two,” Packham explains. “Those include blocking carriers from bidding on Medicare managed care contracts if they can’t offer a plan on the individual market. Those would be kind of severe responses but there’s no easy solutions right now for policymakers.”
The Silver State Health Insurance Exchange, the state’s health insurance marketplace, the Nevada Division of Insurance, the Nevada Department of Health and Human Services, and Governor Brian Sandoval’s office has been working with insurance carriers to try and develop an option for affected individuals in the rural counties.
The National Governors Association, chaired by Governor Brian Sandoval, released a statement this afternoon urging the Trump administration not to slash cost-sharing subsidies. The group is concerned that cutting reimbursements would destabilize the marketplace and cause premiums to spike.