The Affordable Care Act, commonly referred to as Obamacare, seemed headed to the guillotine even before President Trump took office, as reported in our January post. But things change. Since then, a January 27th deadline for Congress to draft replacement legislation was ignored, and last Sunday, Trump told Fox News’s Bill O’Reilly that “we should have something within the year or the following year,” a substantial shift from earlier statements that repeal and replace could happen as early as January of this year.
This was unwelcome news to conservative Republicans who have been advocating for repeal for years, while others began speaking up for “repair” rather than repeal and replace.
As the saga continues, insurers wonder whether to stay in the marketplace in 2018. Many of the largest payers, including Anthem and Cigna, have said they will not commit to participation in 2018 unless the future of the ACA is made clear. They hope for clarification before the April rate-setting deadline, and say that without that, they will be looking to withdraw from the already skinny marketplace.
The future of the marketplace exchanges is at risk not just from the possible repeal of the ACA, but also from the market destabilization the debate is causing. While insurers are hoping for quick answers, the likelihood is a process that is anything but.