Tag Archives: healthcare.gov

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.

What Do the Remaining Payers Want Changed to Keep Participating in the ACA?

It’s no secret many of healthcare.gov’s payers are not happy right now with this part of their business.  As noted in previous blog posts, many insurers have either gone out of business or have exited (or announced their intention to exit) many markets due to large financial losses.  What is it the remaining payers want to be remediated in order for them to remain on the insurance exchanges?  Here are some major sore points that were recently noted by the CEOs of some of the largest payers in the game:

Shore up rules that would restrict extra sign-up periods;

Reduce the grace period for failure in paying premiums (currently set at 90 days);

And allow payers flexibility on setting age-based premiums.

Read more here.

Feds Encourage ACA Insurers to Offer Standardized Plans on Healthcare.gov

A few years right after healthcare.gov opened, I can recall trying to help someone navigate the myriad plans that were being offered.  It was truly overwhelming and that is coming from someone who has been in the health insurance business for almost two decades.  As the marketplace matures, CMS has made recommendations (note:  this is not mandatory) to ACA exchange payers to offer six standardized plans in addition to the plans they may want to offer.

Read more here.