Uncertainty over Obamacare subsidies pushes insurer off North Dakota exchange

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Open enrollment for Obamacare exchanges starts in just over one month, and in North Dakota the options just got worse.

Regional insurer Medica is pulling out of the state’s health exchange for 2018 at the last minute, after state regulators denied the health insurer’s request for a rate increase to account for uncertainty over funding for Obamacare cost-reduction subsidies.

North Dakota insurance commissioner Jon Godfread is concerned that there would be no easy way to reimburse consumers, if Congress approves funding for so-called cost-sharing reduction (CSR) subsidies at some point after enrollees begin paying premiums on their 2018 plans.

CSRs reduce out-of-pocket costs for low-income enrollees. Insurers are required to pay them, but Republicans in Congress have fought funding them, and the Trump administration has only agreed to pay them on a month to month basis.

“Although we understand Medica’s concerns regarding the uncertainty of CSR funding, without knowing the intentions of Congress regarding CSRs, we had to make the decision to move forward with rates that assumed payments would be made,” Godfread said in a statement. “If the Department approved rates requested by Medica excluding CSR payments, and Congress does fund those payments, it is unknown if the Department would then be able to reduce the rates to reflect the changes made.”

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