Christine Stuart / ctnewsjunkie
Gov. Dannel P. Malloy (Christine Stuart / ctnewsjunkie)

Democratic Gov. Dannel P. Malloy and members of Connecticut’s Congressional delegation are criticizing a Republican proposal to repeal and replace the Affordable Care Act with the American Health Care Act.

At an unrelated press conference Wednesday, Malloy said regardless of what happens with replacement efforts “they probably have put a nail in the coffin of the exchanges by withdrawing the mandate.”

The individual mandate required Americans to purchase insurance or pay a penalty. Those penalties helped cover the cost of the law.

“It remains to be seen who will come forward to write in any of the states for any of the exchanges,” Malloy said.

The exchanges provided a way for those in the individual market to purchase health insurance, if they didn’t have employer-sponsored insurance. There was a guarantee that it would be issued regardless of an individual’s medical history.

Under the Republican proposal it’s unclear if those exchanges, which were supported by assessments on insurance companies, will continue to exist.

Malloy said when President Donald Trump said he wouldn’t enforce the individual mandate it substantially “undermined the ability to write health insurance.”

He said he anticipates that it’s going to be very difficult for entrepreneurs and independent contractors to get policies under the Republican proposal. Because it’s going to be difficult for actuaries to predict the health of those who are participating in that pool.

He said Republicans won’t talk about that issue, but they realize what’s going to happen. He said that’s why they’re trying to get it through Congress before Easter in order to avoid public scrutiny.

“They want to get this through the House and the Senate before anyone realizes the true implications of it,” Malloy said.

U.S. Rep. John B. Larson said Wednesday that the process has been rushed and lacks transparency. He pointed out that the Congressional Budget Office hasn’t even had a chance to estimate how much it would cost and how many people would be covered.

U.S. Sen. Chris Murphy on Tuesday reminded his colleagues on the Senate floor that the Affordable Care Act may have had its flaws, but it was a public process. It spanned three committees in the House and those committees held 79 mark-ups on the bill. House members spent more than 100 hours in hearings and heard from 181 witnesses, considered 239 amendments, and accepted 121, according to Murphy.

When it came to the floor, the Senate spent 25 consecutive days on health reform. The second longest consecutive session in history, Murphy said.

“So don’t tell me the Affordable Care Act was rushed through,” Murphy said.

In Connecticut, insurance companies have to submit their rates for 2018 to the Insurance Department regulators by May 1.

It’s a daunting task during this time of uncertainty.

“While it is too early to speculate about 2018, it is our desire to offer individual health insurance on and off the exchange,” ConnectiCare said in a statement Wednesday. “Making health insurance accessible and affordable to the people of Connecticut is a priority for us. We will continue to work with legislators and regulators here in Connecticut to create a stable and sustainable individual health insurance market.”

Eric Galvin, president and CEO of ConnectiCare, said last week that they’ve been “scenario planning,” so that they’re prepared for anything that might happen in Washington.

He said they want to make sure that the new plan, which had yet to be released last week when Galvin spoke to CTNewsJunkie, wouldn’t do any damage to the marketplace.

For instance, “if the individual mandate goes away and there’s no market premium stabilization mechanism other than risk adjustment, then that’s going to be an issue for the market,” Galvin said. “It will make it difficult to determine what premiums will be and it won’t lower premiums, which is the issue.”

Marilyn Tavenner, CEO of America’s Health Insurance Plans, the lobbying group for insurance companies, in a letter to the chairs of the Ways and Means and Energy and Commerce Committees, called for more generous tax credits for consumers in the individual market.

Under the Republican plan the current tax subsidies based on income would be eliminated in favor of tax breaks that would be based on age. Those who are younger would receive a $2,000 tax break and those who are over 60 could receive as much as $4,000, but those tax breaks would be reduced for anyone making more than $75,000 a year. Those subsidies are less generous by about half than the ones currently offered under the Affordable Care Act.

“Tax credits related to age as well as income will help ensure that more people stay covered, and are the most efficient and effective way to allocate taxpayer dollars,”  Tavenner said.

She also expressed concern about changes to Medicaid, which covers 75 million Americans. These are individuals who often churn on and off the program due to fluctuating income levels.

“We are concerned that key components of the proposed new funding formulas starting in 2020 – such as the base year selection and annual increases tied to the consumer price index for medical care – could result in unnecessary disruptions in the coverage and care beneficiaries depend on,” Tavenner wrote.

The conservative Heritage Action Group agreed.

A 2007 Heritage paper described tax credits aimed at families “between 200 percent and 300 percent of the FPL [federal poverty level],” and the American Health Care Act would extend those tax subsidies to those at 850 percent of the poverty level.

Malloy said it’s not lost on him that the changes to Medicaid wouldn’t come until after the next presidential election.