Large Insurers Respond to Calls for Delay In ACA Deadlines With New Lobbying Effort

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By Ralph Lindeman  

Oct. 29 --In a new lobbying effort, big insurers are pushing back against calls by lawmakers in both parties to delay the Affordable Care Act's individual mandate and extend the law's open enrollment period for the uninsured to sign up for coverage, two major insurance associations confirmed Oct. 29.

The insurers said they are concerned that any change in the ACA's deadlines could wreak havoc with their premium rates for 2015, which must be set between April 1 and April 30, 2014, based on their customer base as of March 31, the current deadline for people to sign up for coverage.

In recent days, continuing problems with the federal online health insurance website have triggered calls by Democrats in the Senate for the Obama administration to delay the mandate and extend the sign-up period for coverage beyond March 31 (see previous article). The ACA's individual mandate will impose tax penalties on the uninsured (with taxable income) after March 31.

On Oct. 25, 10 Senate Democrats sent a letter to Health and Human Services Secretary Kathleen Sebelius, requesting that HHS extend the open enrollment period, citing the problems with The letter, spearheaded by Sen. Jeanne Shaheen (D-N.H.), did not say how long the enrollment period should be extended.

Separately, Sen. Joe Manchin III (D-W.Va.) has called for a one-year delay in the individual mandate.

Although Republicans in Congress have long opposed the ACA and called repeatedly for its elimination or a delay of the law's requirements, the recent calls by Democrats have aroused concern among insurance groups, which have started their own campaign in opposition.

AHIP Steps Up Efforts

“We are focused on educating lawmakers and the broader policy community about why the individual mandate and defined open enrollment periods are essential to achieving broad participation in the marketplaces,” Robert Zirkelbach, spokesman for America's Health Insurance Plans, the leading lobbying group for the industry, told Bloomberg BNA in an e-mail.

“Without these enrollment incentives, many young, healthy people may wait to purchase coverage until they need it, driving up premiums for everyone else,” he added.

Zirkelbach said AHIP also is distributing information--including studies, Web links and educational materials--to lawmakers that make the case for maintaining existing deadlines.

High Stakes

The stakes are high for insurers to keep the existing deadlines, according to Timothy Jost, a health law professor focusing on insurance issues at Washington and Lee University School of Law in Lexington, Va.

Delaying the mandate or extending open enrollment “would mean that many fewer months during which health insurers were collecting premiums to offset their 2014 expenses,” Jost told Bloomberg BNA.

“It would also give people that much more time during which they could remain uninsured and sign up at the last minute if something went wrong, although as a practical matter it takes from 15 to 45 days for coverage to become effective,” he added.

“Finally, it would make it that much more difficult for insurers to set their 2015 rates, which they would need to be doing by the time open enrollment closed if it were extended,” he said. “But if it means that insurers would pick up millions of additional customers, it might not be that bad a result.”

Blue Cross-Blue Shield Joins Effort

The Blue Cross and Blue Shield Association (BCBSA) and its members are joining in the effort to counteract calls in Congress to extend the ACA's deadlines, a spokesman for the association confirmed.

“We think it's important for everyone--lawmakers and the public--to understand that the individual mandate is critical to making the insurance reforms, including guarantee issue and community rating, work and to ensuring affordable coverage for consumers,” the BCBSA said in a statement provided to Bloomberg BNA.

“Everyone agreed on this throughout the healthcare reform debate,” the statement continued. “Unless everyone is covered, the reforms included in this law--such as covering people with pre-existing medical conditions--fundamentally do not work. As such, the mandate functions as a consumer protection by keeping rates affordable.”

BCBSA added, “An extension of the open enrollment season is effectively a delay of the individual mandate, with the same serious consequences for consumers.”

Along with Shaheen, Senate Democrats signing on to the Oct. 25 letter to Sebelius were Sens. Kay Hagan (N.C.), Mark Begich (Alaska), Mark Pryor (Ark.), Mary L. Landrieu (La.), Dianne Feinstein (Calif.), Mark Udall (Colo.), Tom Udall (N.M.), Michael Bennet (Colo.) and Martin Heinrich (N.M.).


To contact the reporter on this story: Ralph Lindeman in Washington

To contact the editor responsible for this story: JoAnn Goslin at