Slavitt: Obamacare Should Be Profitable This Year if Republicans Don’t Blow It Up

Jeff Malet/Newscom via ZUMA (Photoshopped by Kevin Drum)


Andy Slavitt ran the Centers for Medicare and Medicaid Services under President Obama, which included responsibility for Obamacare. Here’s a tweetstorm he posted today:

I talked today/last night to 5 health plan CEOs. Won’t use names but: 1 Blues, 1 integrated w hospital, 2 non-profit, 1 VC backed. All 5 health plan CEOs believe they priced 2017 #ACA business & should at least breakeven. Several of the plans beat their ACA membership projections.

Of the 5 plans, w/ current uncertainty none can yet commit 2 participate in 2018. All seemed aware that new #ACA stability reg is coming. One plan said with all the work to be profitable in the #ACA (they hadn’t been), ironic to question participation now.

….They didn’t say, but I will: if there is ambiguity, they will raise prices if they participate. One CEO who has an actuarial background said he would be at single digit rate increases but for all the uncertainty. It sounds like the plans will submit #ACA rates for 2018 high to hold place in line. Big increases all from repeal & mandate uncertainty.

[It] is a shame. Not sure if representative, but single digit if we would wipe uncertainty off table. Still can. But needs to be fast….I think people are so weary of the unpredictability of politics. It zaps energy from their real jobs.

We don’t yet have final enrollment figures for 2017, but it appears that even with double-digit rate increases, uncertainty over Republican repeal plans, and deliberate sabotage from the new Trump administration, signups will be only 2-3 percent lower than last year. That’s a pretty stable market, and probably a profitable—or at least breakeven—one. Fairly modest changes could fix a lot of Obamacare’s existing problems, and higher funding could fix the rest of them.

Instead, we have massive uncertainty in an industry that felt like things had finally settled down after years of work. Slavitt is right: it’s a shame. We can only hope that Republicans will wake up and decide that repairing Obamacare and then taking credit for its success is a better path than blowing up the entire individual health insurance market.