Monthly Archives: October 2016

What Does the Double-Digit ACA Premium Increase for 2017 Really Look Like?

News of a double-digit hike in premiums for coverage purchased on healthcare.gov was announced recently.  Do we really understand what this means?  It is a bit more nuanced than just a blanket premium increase:

  1. The benchmark increases vary by percentage and by location w/some states such as  Indiana, Ohio, and Arkansas seeing minor increases and in some cases decreases;
  2. States that expanded Medicaid coverage and those that did not grandfather transitional plans seem to have fared better overall in the marketplace;
  3. States whose insurers low-balled premiums to gain more market share were more often than not having to make drastic increases in premiums the following years to make up for often huge financial losses incurred from this gamble;
  4. Most enrollees will be shielded from the bulk of the premium hikes because they qualify for federal subsidies.

Read more here.

ACA Marketplace Analysis: Why Some Payers Made it Work and Others Didn’t

The news over the past few months have been pretty tough for payers on the ACA health insurance exchanges.  Many payers across the country either went under or announced plans to radically reduce or stop offering policies on the exchanges.  However, what has not been widely publicized are the payers that are thriving on the exchanges and have turned a profit.  What is the secret sauce for these payers?  It’s part luck, really good actuarial analysis going into the marketplaces, and some well-placed figurative bets.

Read more here.

More Signs Prove Bad News for Anthem-Cigna Merger

In what is looking more like an acrimonious divorce rather than a joyful wedding, a federal judge has ordered Anthem and Cigna to turn over ‘alleged documents’ that show breeches to the terms of the merger.  Cigna allegedly doesn’t feel Anthem is adequately preparing for the trial against the federal government that is to begin shortly.

This is reminding me more of War of the Roses but before the two parties even walk down the aisle.  If by some miracle this merger goes through, I can’t imagine there could be any ‘happily ever after’ that could come of this.