UnitedHealth Group Inc., Aetna Inc. and Humana Inc. are all scaling back their participation in Obamacare for next year. According to the Kaiser Family Foundation, premiums are slated to increase by an average of 9% next year, when weighted by plan participation. Hints about why those 24 million people are opting to go without insurance can be gleaned from the traits they share: They tend to be poor, live in states that decided against expanding Medicaid, or may be undocumented immigrants.
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“What’s harder to measure is whether the provision of insurance-or the moving from uninsured to some form of insurance-whether that leads to better health”, said French. In many cases, these subsidies will cover the bulk of the cost of the insurance. With the impending pullout of major health insurers – including Aetna, UnitedHealth, and Humana – Pinal County is just one place around the country where Americans will be left with few, if any, choices for coverage. “Regardless, we remain confident that the majority of Marketplace consumers will have multiple choices and will be able to select a plan for less than $75 per month when Open Enrollment begins November 1st”.
“We could be looking at about 1 in 4 counties in the USA with just one exchange insurer next year, though this could change between now and open enrollment in November”, said Cynthia Cox, associate director for the Kaiser Family Foundation Program for the Study of Health Reform and Private Insurance. That said, the report is sobering news for many consumers, about 11.1 million of whom are now covered by plans sold on the exchanges. It will sell coverage on exchanges in 242 counties next year, down from 778.
Those counties are in and in Delaware, Iowa, Nebraska and Virginia.
Experts suggested several ways to lure healthier people into the exchanges, including increasing the penalties for not having coverage and boosting the subsidy levels to make it less expensive to obtain insurance. Co-ops that have made a decision to stay in the market for 2017 are calculating ways to make up for losses in previous years – expanding policies to company’s larger than the individual and small business market and raising premium rates by 10 percent in 2017. Until that happens, insurers were expecting the federal government to help with the costs of caring for the early enrollees. But it only plans to offer policies in three states next year, Nevada, Virginia and NY.
In Aetna’s case, the company claimed that it was inundated by higher-than-anticipated costs, particularly due to expensive specialty drugs. Since then, Aetna found that its performance on the exchanges in the second quarter “showed a significant deterioration”. Consumers in all or part of states including Georgia, North Carolina and SC may have only one insurer option when exchanges open for business next year.
This suggests that there are two ways to address the problem with ensuring the exchanges are viable.
“Really there’s no competition because the prices are set by and large by the federal government or by the insurance companies”, he said.
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But even Molina has scaled back its growth plans.
