Many Insurance Companies Stay Quiet On Health Care Debate

With AHCA coming to the house floor for a highly anticipated vote, some of the biggest stake holders that are closely following the health care political circus are health insurance companies around the country. NPR's Kelly McEvers talks with Professor Sabrina Corlette of the Center on Health Insurance Reforms at Georgetown University about what she has heard from the health care industry.

AUDIE CORNISH, HOST:

One of the groups with the most invested in today's events on Capitol Hill is the health insurance industry, yet it's been among the most quiet in this ongoing debate about how to change the health care system. Sabrina Corlette studies health insurance reform issues at Georgetown University's Health Policy Institute. She joins us in the studio. Welcome back.

SABRINA CORLETTE: Good evening.

CORNISH: So given what we have heard today from the president, also from Congressman Byrne Just now, they keep saying Obamacare is collapsing. It's going to collapse right now, too bad we didn't do anything. From your position studying the health care industry, what do we know about, like, the state of things?

CORLETTE: Well, there's two parts to that issue. First of all, I would just say straight out that that is just wrong. We've seen analyses from Wall Street that have said that the insurance industry on these marketplaces is turning it around financially, that they are starting to make money or at least break even on these marketplaces. The Congressional Budget Office has come out and said the Affordable Care Act marketplaces are stable.

The second thing though is that this could become a self-fulfilling prophecy because the more uncertainty you sow in the marketplaces about the rules that the insurance companies have to operate by, the less likely they're going to want to participate, and the more likely, if they do participate, they are to raise rates. So the more you say it's collapsing, the more you kind of...

CORNISH: Make it happen.

CORLETTE: ...Make that happen, exactly.

CORNISH: Now, health insurers set their premiums in May. That's just a few weeks away. Could this legislation impact that process? I mean, especially if lawmakers are going around saying we're going to move on to other things.

CORLETTE: Absolutely. I mean, they only have - insurance companies only have a few weeks to put their plans forward for 2018. And they really need to know the rules of the road. Now, it may well be that the Affordable Care Act will be the law of the land for the foreseeable future.

But there's still a lot of uncertainty about how Secretary Price at the Department of Health and Human Services and how the Trump administration is going to run those marketplaces, what investment they'll put into that and also whether they'll change the regulations that kind of are where the rubber meets the road on how the insurance companies are supposed to operate.

CORNISH: So even though there isn't a full replacement on the way, you're saying the Trump administration's Health and Human Services secretary could make changes in the way the law is regulated that would make a real difference.

CORLETTE: Absolutely. And there are some big decisions that the Trump administration needs to make that will affect very strongly the insurance companies' pocketbooks. So I think at this point, all eyes will be pivoting to the administration. But there's only a very limited window of time for insurance companies to have that certainty.

CORNISH: Before I let you go, their - the insurance companies, their silence is deafening. How come?

CORLETTE: You know, that's a great question. And some have come out against the replacement bill that was on the floor today. Some had sort of mixed responses. We like this provision but not that provision. But I think many of them are being very cautious about burning bridges or making this administration angry with them.

CORNISH: Sabrina Corlette studies health insurance reform issues at Georgetown University. Thanks so much.

CORLETTE: Thank you.

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