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Where you live will soon determine what health insurance you can get


People in need of medical attention wait outside Greensville County High School, in Emporia, Virginia, June 25, 2017, for free medical aid by Remote Area Medical. The nonprofit volunteer medical relief corps provides free health care to people in remote areas of the US.

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People in need of medical attention wait outside Greensville County High School, in Emporia, Virginia, June 25, 2017, for free medical aid by Remote Area Medical. The nonprofit volunteer medical relief corps provides free health care to people in remote areas of the US.

Both Collins and Cox said insurer participation in Obamacare markets could decrease next year because of looming question of Trump administration actions.

Specifically, they said, insurers are not sure whether the Trump administration and Congress will continue paying them billions of dollars in so-called cost-sharing reduction subsidies.

By law, insurers must give low-income Obamacare customers who buy certain kinds of health plans, known as silver plan, reduced charges for out-of-pocket health expenses, including co-pays, coinsurance and deductibles.

The federal government is supposed to reimburse insurers 100 percent for those subsidies. But a court case challenging the Obama administration’s spending of that money without specific congressional appropriation of those fund, as well as President Donald Trump’s musing that he might end the CSR payments that give consumers discounts, have led some insurers to hike prices significantly for 2018 or pull out of the Obamacare markets altogether.

Big insurer Anthem last month said it would effectively exit Ohio’s individual plan market next year because of the CSR question, as well as other issues.

Anthem’s departure left more than 15 Ohio counties on track to have no insurers selling Obamacare in 2018.

Another big question for insurers is whether Obamacare’s individual mandate, which requires most Americans to have some form of insurance or pay a tax penalty, will either be repealed by a new Republican health-care law or not be enforced by the Trump administration.

“Insurers need to know the rules of the game for next year,” Cox said.

“If they don’t know the rules, some won’t want to play at all and others will have to raise rates much higher than they otherwise would,” Cox said.

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