Without marketplace fix in budget bill, insurers likely to spike premiums

The U.S. House on Thursday passed a $1.3 trillion, two-year omnibus spending bill that didn't include funding for cost-sharing reduction payments or a federal reinsurance program (Source: “With no fix in omnibus budget bill, insurers set to hike premiums, rethink selling individual plans,” Modern Healthcare, March 22, 2018).

The omnibus bill, which the Senate must pass by midnight on Friday to avoid a government shutdown, marks what most feel was a final shot at passing measures to bring down premiums in the individual market before plans must decide where to sell and how to price coverage next year. Absent that lifeline, insurers will likely be raising premiums and rethinking their participation in the individual market in 2019.

A $30 billion reinsurance program—health insurers' top priority—was dropped from the spending bill along with funding for cost-sharing reduction payments on Monday. That came despite bipartisan support for the package after lawmakers on both sides disagreed over policy demands from the Trump administration, including the auto-renewal of short-term plans and applying anti-abortion language to the cost-sharing payments.

Without a federal reinsurance program that would have helped subsidize care for high-cost plan members, some health insurers could hike premiums further or exit the individual market altogether.