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A former US representative and ex-president of the National Association of Insurance Commissioners expects financial turmoil in the healthcare industry as Obamacare repeal-and-replace legislation lurches through Congress.
The intersection of healthcare finance and politics features an assortment of twists and turns. Earl Pomeroy knows the terrain as well as the back of his hand.
Pomeroy served as state insurance commissioner in North Dakota from 1985 to 1992. From 1990 to 1991, he was president of the National Association of Insurance Commissioners.
From 1993 to 2011, the Democrat represented his state in the US House of Representatives and served on the Ways and Means committee. Now, he is working in Washington as senior counsel at Atlanta-based law firm Alston & Bird LLP.
Last week, HealthLeaders quizzed Pomeroy on efforts in Washington to repeal and replace the Patient Protection and Affordable Care Act, including his forecast for the financial impacts on healthcare providers and payers.
The transcript below has been lightly edited.
HLM: Before the ACA, there was no functioning individual insurance market. The individual market created through the ACA-spawned exchanges is losing carriers and teetering perilously. Gauge the fate of the individual market.
Pomeroy: The individual insurance market has long been troubled. [When] I was North Dakota insurance commissioner, we had nothing but trouble in that area.
One company, Blue Cross Blue Shield, essentially made the individual market available. So, pre-ACA, there were an awful lot of jurisdictions that did not have competitive markets.
The exchanges have had a variety of problems, and there were missteps by the Obama administration in the implementation of the Affordable Care Act that compounded some of the difficulties for insurers trying to operate on the exchanges.