The Trump administration has proposed changes to the Obamacare individual insurance market that insurers have said are needed for them to keep selling the plans as Republicans work on a replacement program.
The changes to tighten enrolment and collect unpaid premium payments aim to cut down on signups from people after they are sick, which insurers say has created an unprofitable mix of healthy and sick customers.
Humana Inc on Tuesday said it was pulling out of this market altogether for 2018 and Anthem Inc. and Aetna Inc have said that without changes, they might not take part after 2017.
President Donald Trump and congressional Republicans campaigned last year on a promise to scrap the 2010 healthcare law that is a key legacy of Democrat Barack Obama's presidency. But they are struggling to agree on a replacement for the law, which enabled up to 20 million previously uninsured Americans to obtain health coverage.
The proposed new rule, issued by part of the US Department of Health and Human Services, sets out changes that are meant to shore up the system developed under Obamacare. It is unclear which elements of this system could survive in the Republican replacement.
They come as the administration backed off implementing tougher oversight of the individual mandate, the requirement for all Americans to have health insurance or pay a fine, that was due to go into effect for 2016 taxes.
The Centers for Medicare & Medicaid Services, part of the US Department of Health and Human Services, on Wednesday proposed the new rule that includes verifying the status of people enrolling in the plans.
The rule also proposes insurers can collect unpaid premiums from members when they sign up with the same issuer again, with the goal of establishing an incentive for continuous coverage.
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