By Barbara Feder Ostrov / California Healthline

Covered California’s premiums are expected to rise significantly next year, but the head of the state’s insurance exchange said the Trump administration’s legal bid to dismantle protections for people with preexisting medical conditions will likely not contribute to the increases.

Health plans will only be “pricing for the changes that they can absolutely see,” Peter Lee, executive director of the agency, told California Healthline on Wednesday. And because the legal challenge will take time to work its way through the courts, California will have “an opportunity to implement state protections” should they be needed, Lee said.

In fact, Californians would already be temporarily cushioned by existing state rules that protect people with preexisting conditions for 12 months if that portion of the Affordable Care Act is struck down. The preexisting conditions clause prohibits insurers from refusing coverage to people with prior illnesses, or charging them more because of it. Lee is expected to address the matter at a Covered California board meeting later today.

Last week, the administration announced it would not defend the key pillars of the ACA in court. It argued that those provisions, including the health law’s protection for people with preexisting conditions, should be declared unconstitutional.

One federal health care move that will factor into Covered California’s 2019 premiums, Lee said, is the decision by Congress to eliminate the tax penalty on people who choose not to buy insurance starting next year.

Many experts believe that without any consequences for not having insurance, more young and healthy people will decide to forgo it, leaving health plans with a higher concentration of elderly and ill — and more expensive — people.

Kaiser Health News
Kaiser Health News

Kaiser Health News (KHN) is a nonprofit news service committed to in-depth coverage of health care policy and politics. And we report on how the health care system — hospitals, doctors, nurses, insurers, governments, consumers — works.

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