HHS chief hints at tweaks to ObamaCare marketplace

HHS chief hints at tweaks to ObamaCare marketplace

Health and Human Services (HHS) Secretary Sylvia Mathews Burwell on Wednesday sought to calm fears about the still-shaky ObamaCare marketplaces in the final stretch before this year’s sign-up period.

Speaking to health insurance executives in Washington, Burwell stressed that the White House is listening to insurers as some of them worry about staying afloat in the ObamaCare business.


She ticked off several of the tweaks that the administration has already made this year and hinted that more changes were in the works.  

Burwell highlighted the Obama administration’s move to crack down on people signing up for coverage past the deadline and added: “We’re planning to pilot additional changes.”

She said the White House has "heard your concerns about potential threats to the [Affordable Care Act’s] risk pool,” referring to the balance of healthy and sick people in the marketplace.

Health insurers have griped about some pieces of ObamaCare since its launch in 2013, though many of those concerns were amplified this year after companies saw a full picture of their customers’ health costs and needs for the first time.

Many insurers enrolled sicker people than expected. As a result, insurers of all sizes have proposed premium hikes this year that are far more than previous years, though still less than some analysts predicted at the start of ObamaCare.

Burwell said the White House was committed to helping insurers stay on the marketplace — a move that would help preserve competition.

“We want to make sure that issuers like you can sustainably serve every type of customer,” Burwell said. “We also want to make sure that those who take on the highest-risk enrollees get the compensation that they need.”

Insurers have repeatedly pointed to problems with the funding programs within ObamaCare that were intended to help protect companies from high costs. That includes the risk corridors program, which is temporary, and risk adjustment, which is permanent.

Burwell highlighted recent changes to the risk adjustment program, which she said will now be based on a “fuller picture of your enrollee's health status” — particularly, prescription drug use.

She did not acknowledge the fate of risk corridors, a key program that is now at the center of lawsuits by a half-dozen insurers because of financial shortfalls. The Department of Justice filed motions to dismiss two of those cases last week, arguing that federal government does not actually owe that money.

Summing up this year's enrollment challenge, Burwell acknowledged the healthcare law has “encountered bumps” but maintained her same sunny outlook.

“This is a transition,” she said. “Transitions always present challenges, but they also present opportunities.”