EDITORIAL: Action needed to rescue ACA exchange

Feb. 22--A town hall meeting on the future of the Affordable Care Act scheduled for Thursday took on fresh urgency with last week's announcement that Humana would no longer participate in the law's health insurance exchanges.

Humana, the sole ACA exchange insurer remaining in the Knoxville area, announced plans to exit the ACA exchange next year, citing an "unbalanced risk pool." The announcement came about a month after a federal court rejected a proposed merger with Aetna.

Though the company remains profitable overall, Humana has lost money on exchange policies. Industry experts estimate the exchanges' risk pools need 40 percent of policyholders to be relatively young and healthy to be profitable; last year they made up only 28 percent of the risk pools.

About 40,000 East Tennesseans who rely on the Affordable Care Act for health insurance could lose coverage. Republicans in Congress and President Donald Trump have said they will repeal and replace the law, but no consensus has emerged.

The future of the law is the subject of a town hall meeting titled "ACA: Repeal, Replace or Repair?" at Whittle Springs Middle School at 6 p.m. on Thursday.

Panelists include Jerry Askew, senior vice president for government relations at Tennova; Carole Myers from the University of Tennessee College of Nursing; Michael Holtz with the American Cancer Society Cancer Action Network; Matt Harris from the UT economics department; and Richard Henighan from the Tennessee Health Care Campaign.

Several elected officials, including Knoxville Mayor Madeline Rogero, plan to attend.

"This is not a partisan issue or a partisan meeting, nor is it a rally or protest," Rogero wrote in a guest column published last weekend by the News Sentinel. "It is a chance for community members to express their thoughts, concerns and experiences with the Affordable Care Act and health care access in general."

Tennessee Republican Sen. Lamar Alexander is playing a key role in shaping future changes as chairman of the Health, Education, Labor and Pensions Committee. He likens the exchange to a bridge in danger of collapse that needs emergency repairs to stay up while a new span is built. The Centers for Medicare & Medicaid Services issued new rules last week aimed at stabilizing the exchanges, but more needs to be done.

The ACA has been successful in its primary goal of providing access to insurance to more Americans. At least 20 million people who did not have insurance before the law went into effect now have coverage, and more would be covered if Tennessee and 18 other states had not opted out of Medicaid expansion. Making the numbers work for insurance companies has been the law's Achilles' heel.

Alexander and his colleagues in the Capitol will need to find a way to mend the wound. The citizens who will attend the town hall and 40,000 of their neighbors are depending on them.

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