Administration Official Is Unsure If Individuals Will Sign Up For Obamacare

Official says it's hard to predict what people will do with double-digit increases, bare counties, and instability in marketplace

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August 31, 2017

An administration official on Wednesday did not give a clear goal for Obamacare enrollment and was unsure as to whether or not individuals would sign up for coverage.

"There's so many factors in play right now in terms of whether people are going to want to sign up for next year," the official said. "I think it's also very difficult when you have double-digit increases going on across the nation, there's a lot of instability in the marketplace, I think we've heard stories of bare counties and even though those have been addressed, the fact that you know you're sitting in a county and there's been some question about whether you're even going to have insurance or not, or you're going to have to pay a penalty, I think those are issues for those individuals."

"You're having new insurers that are coming into the marketplace so for people it could be a brand new doctor for them. They could have things that were covered that are not covered. They could have medications that have been changed. So I think given all of those factors and those issues that are going on in the marketplace, it's kind of hard to predict what people are going to do," the official said.

The administration official noted that more news about the cost-sharing reduction payments, which have been put in question after some members of Congress called them unconstitutional, would be coming soon.

Some insurers have said they plan to increase premiums due to heightened uncertainty, and if the payments were made, premiums would go down.

The official countered that argument, however, by saying even though the payments have been paid over the past three years, that still did not solve the problem of the double-digit rate increases.

The official added that patient-centered reforms giving individuals the information they need to make decisions about their health care choices, instead of the government, are imminent.

"Primarily our focus is on putting people and patients first," the administration official said. "We're also looking to empower patients across the board so that we're coming up with policies—it's about putting individuals first and giving them the information that they need so they can make better decisions."

The official explained that over the last 10 to 20 years, everyone from doctors to hospitals to the pharmaceutical industry has been heavily regulated. "There's a lot of frustration with all the new regulations so we're looking at trying to figure out how to make things easier. So we'll have a massive deregulation for providers and for health care delivery sites."

In addition, patient-centered reforms mean putting individuals into the equation so they can make cost and quality decisions for themselves, instead of the federal government.

"Let's say there's some hot new thing that comes out in the market and you know somebody wants that," the official said. "Are we having the agency then make all of those decisions about what's covered and what's not covered or are we sort of empowering people to say okay here's the dollars we have, let's think about, let’s let the individual make those decisions for themselves?"

Another example is data on the hospice quality system where individuals are given information to compare what facility and quality outcomes are.

"I hope to get that level with actual price and quality so that there's information," the official said. "In some cases in Medicare or if you go to a hospital or go to doctor's office it might actually cost you more depending on the way the billing works. And we need to let people know and make sure they have that information. Then they have the incentives to make the decisions that are best for them."

Medicaid, meanwhile, was structured to be a program for the most vulnerable population: the aged, blind, disabled, and pregnant women. However, there are now more able-bodied individuals being put on this program.

"I think it's easy to hand out an insurance card," said the official. "I think we have a higher mission to help these people not only with their health care coverage but to help them move out of poverty and to support them in doing that and to figure out how we can structure the program in a way that supports their independence."