CMS: Drop in insurer applications for 2018 'further proof the Affordable Care Act is failing'

As Senate Republicans try to coalesce around a replacement for the Affordable Care Act, the CMS Monday said it had "further proof that the Affordable Care Act is failing."

The agency announced that 141 issuers submitted initial applications to offer coverage in at least one county in the 39 states covered by the federal exchange. That's down from 227 issuers last year who had submitted applications, a 38% decline.

CMS Administrator Seema Verma said in the release: "Insurers continue to flee the exchanges, causing Americans to lose their choice for health insurance or lose their coverage all together. These numbers are clear: the status quo is not working. The American people deserve healthcare choices and access to quality, affordable healthcare coverage."

Insurers have several months to make a final determination on where to sell, and the release said the number will fluctuate through the end of September, when they sign final contracts.

In 2017, 167 issuers ultimately signed contracts.

The "status quo" language echoes that of Republican politicians who have been working to repeal the ACA. At the beginning of the year, Senate Majority Leader Mitch McConnell wrote in an op-ed that Democrats "can join with us to bring relief to millions who've been hurting under Obamacare, rather than simply continuing to stand by a failing law that's unraveling and harming even more Americans. Either way, we have to act, because American families deserve better than Obamacare's failing status quo."

More recently, McConnell has threatened Republicans wavering on his ACA replacement plan that the status quo would collapse the markets and that the GOP will have to work with Democrats on shoring up the exchange system. Democrats sent McConnell a letter Monday suggesting the first actions could be to appropriate money for cost-sharing reduction payments to insurers and make federal reinsurance funding permanent for exchange plans. The letter also suggested that there could be some premium support for buyers above the current subsidy limit to those at 400% of the federal poverty level.

Last month, the HHS reported that 47 rural counties had no insurers signed up and more than a thousand counties could have only one seller on the exchange. Less than two weeks later, Centene said it would sell in Missouri counties that no company had signed up for.

That release quoted Verma saying: "This is yet another failing report card for the Exchanges. The American people have fewer insurance choices and in some counties no choice at all. CMS is working with state departments of insurance and issuers to find ways to provide relief and help restore access to healthcare plans, but our actions are by no means a long-term solution to the problems we're seeing with the Insurance Exchanges."

Democratic Sens. Ron Wyden and Patty Murray wrote to the Government Accountability Office in June, complaining that HHS could be violating restrictions on federal appropriations through political tweets and videos that support the enactment of pending legislation.

However, past HHS news releases also took a political tone at times. The Obama administration, which put out a release Jan. 10 trumpeting higher enrollment in ACA exchanges, said the data refuted "predictions that 2017 premiums changes would lead to sharp declines in enrollment and a so-called death spiral."