Connecticut Keeping Close Watch On ACA Reform

Jan. 26--As both the Trump administration and Congress begin repealing Obamacare, the companies in Connecticut most affected by the law aren't anxious to talk about it.

Cigna, which sells Obamacare plans in seven states, had 176,000 customers in that segment in November. CEO David Cordani said two weeks ago that Cigna expects to add 100,000 people to its Obamacare business in 2017, but a Cigna spokesman declined comment this week on the executive action signed by Trump that begins dismantling the Affordable Care Act.

Aetna and ConnectiCare didn't respond to questions on the executive order.

ConnectiCare has almost half the Obamacare customers in Connecticut. Aetna had more than 800,000 Obamacare customers nationwide in 2016, but dramatically scaled back where it would sell this year. It said the counties where it was staying represented about 20 percent of its Obamacare customers.

UnitedHealth Group, which does not sell Obamacare plans, also didn't respond to questions.

All health insurers could be affected by a repeal of the law because it affects far more than just Obamacare plans, or even the billions in taxes on the industry.

"People think the ACA [Affordable Care Act, or Obamacare is solely about the exchanges, or the Medicaid expansion," said Vicki Veltri, chief health policy advisor to Lt. Gov. Nancy Wyman. "All of the residents of the state are impacted one way or another."

Millions of people, including many in Connecticut, have been added to Medicaid because of federal support expanding eligibility. Many insurers -- including Aetna -- manage state Medicaid programs as managed care providers.

Also, the law eliminated lifetime caps on benefits, which were in 60 percent of employer-offered plans in 2009, according to the Obama administration.

Aetna and UnitedHealth do not lobby through the health insurers' trade group, which has been muted in its public statements about plans to repeal and replace the law. The American Health Insurers Plans spokeswoman told reporters: "It is too soon to tell whether this order specifically will lead to changes."

There are many bills -- or even outlines that haven't been written into legislative language -- circulating in Congress now. One would allow states that made Medicaid more generous to keep federal funding for that expansion. Others would put a per-capita cap on Medicaid matches. Now, Medicaid is a right for those who are poor enough to qualify. Under some proposals, the federal government would send a specific amount of funding to each state, and they'd have to work out how much care they could pay for with it.

"There's no question that changes that are being bandied about around Medicaid would present very big challenges for the state of Connecticut," Veltri said.

"All of us are watching the daily events in Congress and elsewhere to see what might happen," she said. "People are not sitting on their hands, but in terms of specific proposals, we are waiting for Congress to follow through with its promises."

Veltri said that individuals who live in Connecticut and buy Obamacare policies with subsidies collectively receive $400 million in discounts to premiums.

"Repealing without replacement can send dramatic waves of uncertainty not only to consumers but to the market," Veltri said.

But even with all the talk about repealing Obamacare, Connecticut residents have continued to sign up for Obamacare plans that started on Jan. 1.

Nearly 107,000 people are signed up for the plans so far, and open enrollment continues until Jan. 31. Last year, there were 116,000 signed up through the end of January, though close to 8,000 never paid a premium, so they lost coverage.

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