President Donald Trump, along with Congressional Republicans, have repeatedly said that if Obamacare isn't repealed soon, then the health care law will eventually collapse under its own weight. That appears to be exactly what's in store in Tennessee's third largest city.
Knoxville, Tennessee, could soon become the first U.S. city where Obamacare collapses altogether. Currently, there is only one health insurer that offers coverage on the Obamacare exchange to roughly 40,000 people who live in the 16 counties in and around Knoxville, CNN reported. The estimated population in Knoxville in 2015 was 185, 291.
Humana, the only insurer servicing patients there in 2017, announced recently that will pull out of the exchange in 2018. Humana was the first health insurance provider to announce earlier this year that it planned to pull out of Obamacare exchanges nationwide. The company cited the fact that it stood to lose more than $45 million as a result of participating in the exchanges.
“We are again seeing signs of an unbalanced risk pool based on the results of the 2017 open enrollment period. Therefore, we’ve decided we can’t continue to offer this coverage in 2018," CEO Bruce Broussard reportedly told the company's investors at the time.
It's possible that another provider could fill the gap created by Humana, but given the Republicans' vow to repeal and replace the 2010 law, and the uncertainty that it has created, other insurers are weary to jump in. The deadline for health insurers to say whether they will do business in the Tennessee exchanges is July 1, according to CNN.
Julie McPeak, Tennessee's insurance commissioner, said she's not holding her breath.
"I'm not optimistic that one of our existing insurers would like to expand their coverage area without some changes to the regulatory system, either by Congress or the administration," McPeak said.
If no other insurers join the Tennessee exchange before July 1, Knoxville area patients would still have the option of buying insurance outside the exchange from one of three providers: Aetna, Freedom Life Insurance, and Tennessee Rural Health. However, patients who choose to purchase a plan from one of those three providers would not be able to apply any federal subsidies for which they may be eligible.
Tennessee's two Republican senators, Lamar Alexander and Bob Corker, have introduced a bill that would allow patients receiving subsidies to apply that money to plans outside of Obamacare exchanges. The bill would also exempt those in Tennessee who lose coverage on the exchange from paying the penalty.
Tennessee has been particularly hard hit by Obamacare. In recent years, two other health insurers — United Health and Assurant Health — dropped out of the state's exchanges. And in 2015, co-op insurer Community Health Alliance, fell flat.
“At some point, on behalf of the American people, Congress and the administration have to resolve the issues that are driving up health care costs, limiting choices, and causing the exchange market to spiral downward,” Corker said in a statement last week. “However, in the interim, we must take steps to ensure people...have the opportunity to purchase health insurance off the exchange in the individual market.”
While Republicans' effort to repeal and replace Obamacare failed to garner enough votes in the GOP-controlled House of Representatives, the White House signaled this week that it is drafting new legislation that could satisfy both moderate Republicans and those in the Freedom Caucus.
The text of that new legislation has not been officially released yet.
Despite the clear challenges that lie ahead, Trump vowed during an interview with the Financial Times over the weekend to get the job done.
"One way or the other, I promised the people great health care. We are going to have great health care in this country. Now, it will be in one form or another. It will be a repeal and replace of Obamacare which is the deal that is being negotiated now," Trump said, according to Politico.
It's not clear, though, whether the "deal" Trump spoke of would be the result of negotiations with the conservative Freedom Caucus or moderate Democrats. The president signaled after his initial health care defeat that if the Freedom Caucus wasn't willing to negotiate, he might rely on the support of moderate Republicans together with the support of moderate Democrats.
(H/T: Daily Caller)