Will Obamacare really explode?

Politico: The case that Obamacare is collapsing is driven by this uncertainty, which is making insurers pull out. What does this fight do that uncertainty?

Levitt: The uncertainty insurers had been facing was what would come next after the Affordable Care Act, after this repeal-and-replace debate. It now looks like, for the foreseeable future, the Affordable Care Act is what’s coming next. So in some sense, there is greater certainty for insurers now in knowing that the ACA is here to stay. The big uncertainty has come in what the Trump administration may do administratively.

The most immediate risk is what happens with cost-sharing subsidy payments to insurers. These are the payments that are at issue in the lawsuit that the House filed against the HHS, challenging their authority to make these payments. If the administration decides to stop those cost-sharing subsidy payments, you could see insurers running for the exits.

Politico: So there is a case that in some ways this uncertainty is at a new low after this. So that’s a case the marketplaces might do better, right?

Levitt: Right, so those insurers know that the ACA is here to stay. But what they don’t know is what the administration might do to undermine the law or allow it to collapse. This is a program that has to be operated for it to succeed. So, for example, for insurers to be profitable in this market, there has to be active outreach to bring in new customers. The Obama administration was active in doing that outreach, including the president himself. It’s hard to imagine President Trump going on “Between Two Ferns” to encourage young people to sign up for health insurance through the ACA.