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The Justice Department’s assertion that critical components of the Affordable Care Act are invalid inserts a new level of uncertainty in the healthcare market for both consumers and insurers.
Federal courts will ultimately decide the fate of provisions including protections for individuals with pre-existing medical conditions and limits on how much insurers can charge based on gender and age.
In the meantime, insurers have to decide where to sell individual coverage and at what rates next year.
Here are three ways the case could affect health-insurance markets, according to a report in the Wall Street Journal.
1. Fewer options in 2019
If companies react to renewed uncertainty by leaving the marketplace, some health-insurance markets could see fewer options, according to Sabrina Corlette, a research professor at the Georgetown University Health Policy Institute.
According to data from the Henry J. Kaiser Family Foundation, about one in four consumers in the individual insurance markets have only one company selling coverage. If companies exit the marketplace, consumers could have no options.
2. Higher rate increase next year
ACA premiums are forecast on average to rise 15% in 2019 because of changes to the tax law that eliminated the ACA’s penalty for being uninsured. Insurers could seek even more substantial double-digit increases in premiums.
3. Lower premiums for some and hard-to-get coverage for others
Should the courts invalidate portions of the law, the premiums individuals pay will vary greatly.
Young, healthy buyers likely would see cheaper insurance, while people with pre-existing conditions could find they are no longer able to get coverage or must pay much more to obtain coverage. Much of that would depend by state, as some states are seeking to pass laws to protect consumers with pre-existing conditions.
