Wonky: Here are some thoughts on the uncertainty insurers face with the latest lawsuit challenging the ACA.
The ACA’s premium subsidies would remain under the Justice Department’s argument. But how would they be calculated? Without community rating, there’s no second lowest cost silver premium.
States would have the authority to reinstate some or all of the ACA’s consumer protections. But how quickly would they act? What happens in the meantime?
A mid-year court decision would be quite chaotic. Could insurers start selling underwritten products? Could they discontinue guaranteed issue products? Would annual open enrollment rules apply?
Guaranteed renewability would still apply. But you can bet insurers would discontinue products that cover pre-existing conditions as quickly as they can. No insurer wants to be left with all the sick people.
Some current marketplace insurers have no history of doing medical underwriting. They might not participate in a market that allows it. With an uncertain future, they have an incentive to try to boost premiums and profits now.
