Remember, Actions Have Consequences

For every day that healthcare.gov remains marginally functional, it seems like a new lawmaker calls for either a delay of the individual mandate, an extension of the individual market open enrollment period or both. This week the Administration issued guidance indicating that they will not penalized anyone who enrolls right up to March 31, which was a change from earlier policy that indicated coverage had to be in force by March 31. But many lawmakers are suggesting that’s just not enough.Image

It’s not just Republican lawmakers, most of whom have been calling for a delay or repeal of all or some parts of the law since the moment it passed, who are calling for a policy change either. Senator Joe Manchin (D-WV) and at least ten House Democrats are calling for a formal individual mandate penalty delay. Senators Dianne Feinstein (D-CA), Jeanne Shaheen (D-NH),  Mark Begich (D-AK), Mark Pryor (D-AR), Mary Landrieu (D-LA), Kay Hagan (D-NC), Mark Udall (D-CO), Tom Udall (D-NM), Michael Bennet (D-CO) and Martin Heinrich (D-NM) have written to Secretary Sebelius asking her to extend open enrollment beyond March 31. Many other Democratic lawmakers have indicated that they are considering jumping on this bandwagon too if healthcare.gov doesn’t start working better fast. Just today, Chairman of the Senate Finance Committee Sentator Max Baucus (D-MT), who is one of the law’s principal authors, told a radio station in his state, “If it looks like Humpty Dumpty isn’t getting good, back together, maybe we should start thinking about delaying the penalties.”

We at the Washington Update certainly can understand the frustrations these political leaders are feeling and we also understand the desire to do SOMETHING to make things right for the millions of Americans who are stuck trying to enroll in coverage. We certainly aren’t individual mandate fans in general and we may have mentioned a few times how we feel about the current open enrollment season. However, as we hear more and more talk about delaying penalties and extending open enrollment, we are reminded of two phrases we often use with our children: “Actions have consequences” and “be careful what you wish for.” As those of us who are extremely familiar with health insurance market processes are well aware, those who have the greatest need to utilize health insurance benefits are the ones who are persevering and signing up for coverage now. So we need healthy risks entering the market too, in order to prevent the crushing premium rates that come with adverse selection. Members of Congress say they know this too, but what they don’t seem to fully understand is timing. Carriers will begin to file next year’s rates and make determinations about whether or not they want to participate in the exchanges for 2015 this coming April. So if enough healthy risks aren’t enrolled by then, we have a feeling a few members of Congress aren’t going to like the news they hear about exchange participation and premium rates for 2015 when they are released next fall, right before Americans go to the polls for the 2014 midterm elections!

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