NYT: “There were close to 250 individual A.C.A. policyholders in Pennsylvania who incurred over $100,000 each in claims and then canceled coverage before the end of the year,” Mr. Scheib testified. “This behavior drives up the cost to insure the entire pool, because people use insurance benefits and then discontinue paying for coverage once their individual health care needs have been temporarily met.”
While state insurance commissioners, who review rates, are trying to balance the needs of consumers and insurers in a turbulent market, insurers have extra leverage this year. At least a dozen nonprofit health insurance cooperatives have collapsed, and several big commercial insurers have decided to cut their losses by limiting their participation in the insurance exchanges, the new marketplaces created under the health law.
The problems threaten to shadow Democrats through Election Day. While Hillary Clinton has vowed to “defend and expand” the Affordable Care Act, her Republican opponent in the presidential race, Donald J. Trump, has seized on the issue. At a rally in Fairfield, Conn., on Saturday, he repeated his vow to repeal the health law, saying consumers were facing rate increases greater than they had ever seen.
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