Health insurance providers are scrambling to figure out what to do with the massive new federal law that President Donald Trump signed last month, as the first major rule changes take effect next week.
The new health insurance regulations could shake up the insurance market for millions of Americans.
A key part of the Affordable Care Act (ACA) will allow insurers to charge higher premiums for people who don’t buy insurance through an employer, such as a hospital.
It also requires insurers to cover people with pre-existing conditions.
Insurers are scrambling for a way to cover the costs of people who may be sick or injured.
“It’s going to change the way people shop and shop for health insurance,” said Sarah Skelton, a senior policy analyst at Avalere Health, a consulting firm.
Insurer executives are also scrambling to decide how to handle the new requirements, which also include setting up an enrollment portal for people to sign up for plans in the future.
“The biggest challenge is that there’s so much going on at the state and local level,” said David J. Weigel, vice president of government relations for Anthem Blue Cross Blue Shield, which has about 100,000 members in 30 states.
“What happens with that will impact all of us.”
Weigel said the ACA “will not be a magic bullet” to help people buy coverage.
Anthem said it expects to lose about $3 billion in 2019 alone, and that its enrollment will shrink from 6.7 million in 2020 to 3.4 million by 2026.
“We are not in a position to be a savior in that regard,” Weigel added.
“But we will continue to work to help the market.”
Health insurers are also grappling with the fallout from the new rules.
“Obamacare has brought together the states and counties into a single regulatory authority,” said Robert Moffitt, a health policy professor at the University of Maryland.
“States are going to be left with the job of implementing it.”
The federal government has given states 30 days to come up with plans that comply with the new regulations, but that could be difficult to do, Moffitt said.
States will also be required to give consumers information about the coverage they are buying, and states will have to offer it to insurers who don.
The federal Department of Health and Human Services is also asking states to provide an annual report on the quality of the insurance they provide, and the cost of coverage, including deductibles and co-pays.
That report is due out in October.
“This is going to create enormous uncertainty in the market,” said Moffitt.
The White House also is looking at how to get states to change their policies.
“You’ve got to have flexibility and flexibility in terms of how you are going about it,” Trump said at the signing ceremony.
“I will ask states to do a better job of making sure they have a plan that is affordable and covers people at the right price point.
We’ll make sure we have states that are able to compete.
I will also ask them to make sure they are doing things that are consistent with the ACA.”
In the meantime, insurers are trying to adjust to the new law.
“As you read this letter, you’re probably thinking: ‘I’m a bit nervous, I’m not sure what’s going on here,'” said Sarah Binder, chief executive of HealthOne Health, which is one of the leading insurers selling health plans in 20 states.
HealthOne said it is now “very aware of the ACA and its impact” on its business.
It is also working with other insurers to figure how to provide more coverage, Binder said.
“Right now we’re very focused on making sure we are providing the best care for the people who need it most,” she said.
In addition, health insurers are looking at ways to help consumers get insurance and get their coverage through a state exchange or a federal program.
Some insurers have already started offering a nationwide online exchange.
But they are working on getting states to create the programs to cover their people, too.
That could take a while, as insurance companies have to figure the details of the federal exchange.