Since President Trump took office, he and his administration have expressed their intention to sabotage the Affordable Care Act by creating instability in state insurance markets. As governors and other leaders across the nation warned, the Trump administration’s actions could threaten the health care and indeed the lives of millions of people across our nation. Unfortunately, here in Virginia, we have seen many of those fears come to fruition.
In the past month, Anthem became the third and largest health insurer to pull out of Virginia’s marketplace. Optima announced it would remain in the marketplace but pull back on the number of localities served.
These decisions mean that hundreds of thousands of people will have to choose new health plans this fall, if they have any to select from. As it stands now, 63 Virginia localities — mostly rural ones, including the entirety of Southwest Virginia — will be without an option to purchase marketplace insurance. Another six localities will only be partially covered. There are 62,000 people with current marketplace plans in those localities who will have no way to maintain insurance. It is unfortunate that the void will mostly be in rural localities, where access to doctors and hospitals and health care in general is already limited.
These developments are heartbreaking for families who need care to lead healthy, productive lives. They are also entirely avoidable.
Instead of solving the problem, the Trump administration continues to sabotage the Affordable Care Act by refusing to guarantee the cost-sharing reduction (CSR) payments that insurers rely upon to offset lost revenue from providing subsidies to low-income individuals. The Trump administration has furthered this instability in the insurance markets by slashing outreach and enrollment efforts by 90 percent, cutting in-person assistance funding by 41 percent and discontinuing enforcement of the mandate that people buy insurance. And, to add insult to injury, those Virginia consumers reeling from the loss of the plans they had will have only 45 days this year in which to choose a new one — if one is available to them at all — because the Trump administration has cut the window in which people can shop for coverage in half.
These actions are deliberate and overt efforts to sabotage a standing federal law. They show no understanding of how insurance markets work and no concern for the impact on people’s lives and health. They are hurting Virginia families and our economy.
The insurers who have reduced their coverage in Virginia have attributed their decisions directly to the instability created by the Trump administration.
In a statement announcing its withdrawal from the marketplace, Anthem cited “continual changes and uncertainty in federal operations, rules and guidance, including cost-sharing reduction subsidies” as a key reason for its departure. In its own statement, Optima said 23 percent of its proposed rate increase is because of the uncertainty around CSRs.
The consequences of the federal instability will be felt by thousands of Virginians. These are real people who deserve better than to have their lives flipped upside down to satisfy a political agenda in Washington. I have already heard from Virginians who worry that they will no longer have coverage for life-saving care. There are people who need organ transplants and major surgery who don’t know if they’ll be able to afford them. It is possible that for some people, life-saving health insurance will not be available for no reason other than where they live.
This problem was and remains avoidable. But Trump and Congress must act, and act quickly, to ensure the continuation of CSR payments and stabilize this market.
We are grateful for the five insurers who are remaining in Virginia’s marketplace, and we want more to come in. I firmly believe that Virginia is the best place in the United States to do business. I want our health insurance market — like our other markets — to be highly competitive, delivering the highest value to consumers. And my administration is actively working to support insurers and encourage competition wherever possible. Virginia’s Board of Insurance is also working with insurers to find a way to help the thousands of people who would be left stranded with no health insurance options. The insurance companies’ decisions are not yet final.
If Trump and Republicans in Congress will work with states like Virginia to improve the Affordable Care Act instead of sabotaging it, we can expand access to coverage, not take it away. As a candidate, Trump promised to make health care more accessible and affordable for everyone. As president, he is doing the exact opposite. It’s time for him to step up and keep his promise to the American people.
Terry McAuliffe, a Democrat, is the governor of Virginia.