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When the Trump administrations replacement for the Affordable Care Act can be expected seems to depend on whom you ask and when.

But the moving target has complicated a clear, nonnegotiable and impending deadline for health insurers: May 3 at the very latest.

The political clarity these businesses are seeking will affect how they design and price 2018 individual market plans, and even whether they participate in the ACAs exchanges at all.

As much clarity as possible by March would be helpful, said Kristine Grow, senior vice president of communications at industry group Americas Health Insurance Plans.

But key Republican figures have offered varying deadlines: March or April, or sometime this year, or maybe even next year.

An ambitious replacement plan might be expected from the party, which has been calling for repeal for seven years. But if announced too late, big changes could restrict quick implementation, especially if theyre released around Novembers open enrollment.

Theres definitely a date, and I would put it sooner than November, it could be into the summer even, where they really have to move forward with legislation or they have to wait another year, said Sandi Hunt, a principal at PwC.

Read: 8 things you didnt realize were in Obamacare

The drawn-out, 18-month process of designing health plans applies to all plans, not just individual ones bought through the ACAs exchanges.

But the firm May 3 deadline for ACA plans is being imposed by the federal government itself, albeit by a different administration than the one that hashed out the deadline in the first place.

This dynamic underscores the complicated and often confusing forces at work as the Trump administration takes charge of a system it has sworn to get rid of.

Health insurers need a stable market, stable rules and a broader pool none of which has been fixed yet, nor does it seem likely it will be in time, said Sheryl Skolnick, Mizuho Securities director of research and senior health-care analyst. They need to know now ideally, I think, but again thats why they are likely to include an out clause in any bid.

Of course, the prolonged uncertainty wasnt entirely unexpected.

Health insurers have likely been doing calculations with and without; a lot of scenario building, Hunt said.

Some are probably submitting proposals with contingency clauses, saying that if these things change, I have the right to change the rates, she said.

Money is top of mind, specifically whether federal dollars key to keeping the exchanges stable will continue to subsidize exchange plans for low- and middle-income Americans.

Health insurers also want the government to make full reinsurance payments for 2016, which are made to stabilize premiums for plans that had to cover people with pre-existing conditions, among other ACA rules.

Related: What is the individual health-insurance market, and why is everyone so worried about it?

But money is also poised to become the primary tool in a repeal-and-replace fight.

With a simple majority, congressional Republicans can only use the budget reconciliation process, which fast tracks legislation that deals with spending or revenue, if they dont gain support from across the aisle.

The application window for insurers opens April 5 and extends until May 3, the final deadline. The back and forth between the Centers for Medicare and Medicaid Services and health insurers extends through Oct. 13, with open enrollment for consumers opening at the start of November.

Dates given by prominent Republican leaders hopscotch around, by contrast.

House Speaker Paul Ryan has said that a replacement plan could be expected in March or April.

Congress starts a two-week recess in early April, making that the soft deadline for a new health-care place, said Cowen Washington Research Group analyst Chris Krueger. But even an April deadline is barely enough time to do the bids for 2018, Skolnick said, adding that timing is tight.

Then, last week, two different dates were put forward: Sen. Lamar Alexander (R-Tenn.), who chairs a key Senate committee on health, said a repeal-and-replace vote would occur this year.

And President Donald Trump projected an even longer timeline for the emergence of a new health law, saying maybe itll take sometime into next year.

We can either do it quickly, as the Democrats did ... or we can do it right, press secretary Sean Spicer said Wednesday, responding to charges that the president was behind on his promise to repeal and replace the ACA.

The ACA itself was not formulated, passed by Congress and signed by President Obama till Obama had been in the White House for 14 months.

But its possible a repeal-and-replace plan could be done faster than the ACA, since you dont have to build the exchanges, Hunt said. The infrastructure of building that was so huge.

In the meantime, over 9 million people have just signed up for 2017 health plans through HealthCare.gov, with up to 18 million total standing to be affected by a repeal.

Even if market-stabilizing subsidies and payments remain in effect, the exchanges success is highly dependent on marketing and enrollment efforts, Hunt said.

Read more: Repealing Obamacare will leave 18 million people uninsured, with even fewer options, CBO finds

Several big health insurers, including UnitedHealth Group UNH, +0.77% , Aetna Inc. AET, +0.30% and Humana Inc. HUM, +0.62% , announced high-profile exits from the exchanges last year. Their qualms predate President Trumps election, which made repeal and replace appear inevitable. Health insurers have long said that the ACA, also called Obamacare, needs major changes in order for participation to be profitable for them.

Insurers including Anthem Inc. ANTM, +0.74% , Centene Corp. CNC, +0.76% , Molina Healthcare Inc. MOH, -1.04% and the Blue Cross Blue Shield plans in various states are worth watching during this time of uncertainty, Skolnick said.

More pulling out could spell further trouble for the individual market, which is individuals who dont have insurance through work or public programs can buy health insurance.

We still need certainty about short-term fixes in order to determine the extent of our participation in the individual market in 2018, said Anthem Inc. Chief Executive Officer Joseph Swedish. And we will be watching developments closely in the first half of 2017 as we evaluate our longer-term strategy for the health-insurance exchanges.

The Health Care Select Sector SPDR XBI, +0.34% has risen 2.6% over the last three months, compared with a 7.6% rise in the S&P 500 SPX, +0.52% .

Read more from the original source:
Republicans keep changing when Obamacare will be repealed yet health insurers have a deadline coming up - MarketWatch