Enrollment in plans through the Affordable Care Act's exchanges continues to grow, and Centene CEO Sarah London said she is seeing growing bipartisan support for the individual market in tandem.
In the first decade of the ACA's life, Republican support for its provisions was rare. In the early days of the Trump administration, House Republicans launched a campaign to repeal the ACA entirely and replace it with a new, GOP-led healthcare bill.
However, London said Tuesday the J.P. Morgan Healthcare Conference that the issue has become far less polarized over time, especially as the marketplaces have stabilized and membership has grown significantly. That growth, and the significant number of members who live in Red States, is "one of the best defense mechanisms" to maintaining the exchanges as well as enhanced subsidies that have helped it to expand.
"This is not as partisan as I think some would like to believe or would believe, relative to Democrats love it and Republicans hate it," London said.
For example, a Democrat-controlled Congress passed the Inflation Reduction Act, which extended the enhanced premium subsidies through 2025. Control of the legislature has since changed hands, but Republicans have taken action around health reimbursement arrangements that London said suggest they see the potential value in the "marketplace chassis."
The marketplaces, she said, appeal to the individual, market interests that are common among Republicans while also assisting with access and affordability, which are mainstays for Democrats.
That said, she acknowledged that there are multiple ways that the future of the subsidies could shake out. There are pros and cons in extending them versus making them permanent, she said. Policymakers could also decide in the future to adjust where the threshold is to qualify for them.
The country is also entering a presidential election year, though London said she doesn't necessarily see either outcome driving a massive overhaul in how regulators view the exchanges and the enhanced subsidies. There is "space to play regardless of what the outcome of the election is," she said.
"There's middle ground there is defined not by politics but by policy, and the idea that there is good policy in the overlapping ven that sits down on top of the subsidies," London said.
The bipartisan interest in the exchanges and the subsidies offers a good foundation that companies like Centene can use to continue innovating in what they offer to consumers, she added.
"We that's going to help get us to a place where this continues to be strong infrastructure to build future individual products," London said.