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Rising Health Plan Rates, Health Plan Consolidation and Competition on the Exchanges

Posted by Susan Donegan on Thu, Aug 25, 2016

We’re reading about health plan changes for 2017 Open Enrollment and the impact of competition on the exchanges. Here’s a summary of interesting news, perspectives and datapoints.

As rates for health plans sold on public exchanges continue to rise higher than expected, causing large insurers to cut and run from this marketplace, brokers and advisers are gathering useful information. Plans in the employer market are borrowing lessons learned from the exchanges in terms of ways to evolve their product designs to be more efficient,” explains Caroline Pearson, senior VP of Avalere. (Employer Benefit Adviser, 8/22/16)

The health insurance market seems to be heading toward more and more consolidation as the major payers Humana and Aetna along with Cigna and Anthem seem to be bent on merging, even though the Department of Justice filed suit to block the deals. More payers are moving outside of the exchanges, the tensions are pointing at some of the faults within the ACA, which may have brought difficulties that stand in the way of keeping revenue stable among top insurers. (Health Payer Intelligence, 8/19/16)

Competition on some exchanges will be diminished next year when three of the nation's largest health insurers — Aetna, UnitedHealthcare and Humana — will sell individual plans in many fewer markets. The departure of several Blue Cross and Blue Shield plans in various states will also hurt. These pullbacks also come on top of the closure of 16 nonprofit co-ops. What's ahead for consumers depends very much on where they live. (NPR, 8/18/16)

Roughly 20 million more Americans have health insurance now than when President Obama’s health care law was passed in 2010. There are still about 24 million adults with no coverage, according to a survey by the Commonwealth Fund, a health research group. That translates to an uninsured rate of about 13 percent, down from 20 percent in 2013. (New York Times, 8/18/16)

Projected Losses on the Exchanges

Tags: ACA, healthcare exchanges, Health plan, HIX




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