Good morning … Open enrollment is two days away.
Every year before open enrollment for the Affordable Care Act begins, the Department of Health and Human Services puts out a report that details the available options and costs in the states using HealthCare.gov.
That report will come out later this morning, but I was able to see it early.
Here's a sneak peek at the upcoming enrollment period:
Premiums are up — but so are subsidies.
Be smart: President Trump's decisions on cost-sharing subsidies have contributed to the law's rising premiums and the resulting rise in subsidies. But he's not responsible for all of this. Competition, for example, took a big hit last year — when President Obama was still in charge.
The debate over the ACA's cost-sharing subsidies has reopened Republicans' broader divisions about how to approach the law as a whole: Do what you can to keep premiums in check and nudge the law to the right; or forego those tweaks and keep insisting on more dramatic changes, even if they can't pass?
My colleague Caitlin Owens takes a look at this divide this morning, and how the failure of repeal-and-replace has changed the party's internal dynamics.
The bottom line: Republicans have separated into two camps: "reality and results" vs. "repeal and replace." Sen. Lamar Alexander's ACA bill could pass the Senate, and would hold down premium increases. Sen. Orrin Hatch's alternative would give Republicans more of what they want — but it almost certainly can't pass.
Sure, we're still physically in the calendar year 2017, and people haven't even started signing up for their 2018 coverage yet. But 2019 is already upon us — and it could end up being just as wild a ride as 2018.
The latest: The Centers for Medicare and Medicaid Services released new rules Friday for how the ACA's exchanges will function in 2019.
What's next: Insurance companies will start turning their attention toward their 2019 offerings as early as this December. They'll be designing their plans and sorting out their provider networks, and will likely need to start submitting that information to the federal government sometime in the spring.
The bottom line: If insurers head into the spring still asking the same questions that roiled the landscape this year — whether they'll get their cost-sharing payments, whether the law will be repealed, whether the individual mandate will be enforced — we could see a second straight year of premium increases, insurer exits, and constant last-minute scrambling.
Congress and the administration have less time than you might think to provide insurers with a stable market for 2019.
Open enrollment for the ACA's individual and small-group markets starts this week. But two much larger enrollment windows are already underway.
Write to us: Medicare and employer coverage has changed a lot, and my colleague Bob Herman wants to know how it's affecting you next year. What are your plan options for 2018? How do they compare to your current coverage? What were premiums and deductibles like? Email him at email@example.com. He's desperately craving your comments.
What we're watching this week: The House will vote on a GOP bill to reauthorize CHIP. ACA open enrollment begins Wednesday.
Tuesday: Senate HELP Committee hearing on implementation of the 21st Century Cures Act. Aetna earnings call.
Thursday: House Energy and Commerce subcommittee hearing on federal oversight of dangerous pathogens.
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