AP Exclusive: Stable costs may shift ‘Obamacare’ politics

WASHINGTON (AP) — After two years of double-digit premium hikes, millions of people covered under the Affordable Care Act will see only modest increases next year, according to an exclusive analysis that highlights the changing politics of health care heading into the midterm elections.

The consulting firm Avalere Health and The Associated Press crunched available state data, finding that “Obamacare’s” health insurance marketplaces seem to be stabilizing. Customers in some states will get price cuts. And the exodus of insurers from the program has halted, even reversed somewhat, with more consumer choices for 2019.

The steady outlook means the health care law won’t be an easy target for Republicans this year, an election issue that’s worked well for them since 2010. But Democrats may also be looking for new talking points. They can’t exactly argue that the Trump administration has wrecked the ACA, so they’re saying that popular provisions like protections for people with pre-existing conditions are still threatened.

The analysis found a 3.3 percent average increase in proposed or approved premiums across 47 states and Washington, D.C., for next year. This year the average increase nationally was about 30 percent. The average total premium for an individual covered under the health law is now close to $600 a month before subsidies.

For next year, premiums are expected either to drop or increase by less than 10 percent in 41 states with about 9 million customers. Twelve of those states are expected to see a drop in average premiums, with New Jersey joining that list on Friday. In six other states, plus Washington, D.C., premiums are projected to rise between 10 percent and 18 percent.

Insurers also are starting to come back. Nineteen states will either see new insurers enter or current ones expand into more areas. There are no bare counties lacking a willing insurer.

Even so, Chris Sloan, an Avalere director, says, “This is still a market that’s unaffordable for many people who aren’t eligible for subsidies.”

Nearly 9 in 10 ACA customers get government subsidies based on income, shielding most from premium increases. But people with higher incomes, who don’t qualify for financial aid, have dropped out in droves.

It’s too early to say if the ACA’s turnabout will be fleeting or more permanent. Either way, next year’s numbers are at odds with the political rhetoric around the ACA, still heated even after President Donald Trump and congressional Republicans failed to repeal the law last year.

Trump regularly calls “Obamacare” a “disaster” and declares it “dead.” The GOP tax-cut bill repealed the ACA requirement that Americans have health insurance or risk fines, effective next year. But other key elements remain, including subsidies and protection for people with pre-existing conditions.

The moderating market “takes the issue away from Republican candidates” in the midterm elections, said Mark Hall, a health law and policy expert at Wake Forest University in North Carolina.

Stability also undercuts Democrats’ contention that Trump has “sabotaged” the program. But Democrats say the ACA remains at risk while Republicans control Washington, and that premiums would be even lower but for the administration’s hostility.

“Voters won’t think that the Trump threat to the ACA has passed at all, unless Democrats get at least the House in 2018,” said Bill Carrick, a strategist for Sen. Dianne Feinstein, D-Calif., whose re-election ads emphasize her support for the health law.

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