Affordable Care Act (ACA) Expansion: Insurers Proceed Despite Legal Challenges

Insurers are pushing ahead with plans to expand their Affordable Care Act offerings next year, even as federal judges debate the constitutionality of the health care law, throwing the future of the Obama administration’s biggest legislative achievement into uncertainty.

Major insurers, including Cigna Corp, Bright Health Inc., Molina Healthcare Inc., Centene Corp., Anthem Inc. and Oscar Insurance Corp. have all announced expected growth for 2020, according to a report published Thursday by The Wall Street Journal.

The insurers’ move mostly reflects the business’ improved finances after previous rate hikes helped revenues catch up to claims costs, the Journal reported. So far, premium increases for 2020 appear to be moderate in many markets.

In the first quarter of 2019, about 13.7 million people enrolled, according to the Kaiser Family Foundation, down from roughly 14.4 million last year, and 18.8 million in 2015. That’s largely because Republicans stripped the health care law of the individual mandate, the financial penalty that required Americans to either purchase health insurance or pay a fee.

But one of the biggest reasons individual-market enrollment has fallen is because of the cost of insurance. In a poll released in January, Gallup said an increase in the rates of insurance premiums in many states is to blame for the increase in the uninsured. For enrollees with incomes who don’t qualify for government subsidies, the resulting hike in rates could ultimately drive them out of the marketplace.

To keep rates down, the Journal reported, many insurers plan to offer a smaller selection of health-care providers. Some insurers, like Bright and Oscar, could just build their plans around a single major hospital system.

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