This week, newspapers donned headlines about the sharp rise in premiums for health insurance plans available this open enrollment season on the ObamaCare exchanges. Increased premiums paired with sky-high deductibles have consumers paying for catastrophic health insurance at comprehensive-plan prices. Ed Morrissey argues that consumers have become “victims of a bait-and-switch scheme that the government would vigorously prosecute – if it wasn’t masterminding the scheme itself.”
UnitedHealth Group just announced they expect to lose $700 million in the Obamacare exchanges and are seriously considering withdrawing from the program in the coming year. Why is this happening? Because nowhere near enough healthy people are signing up to pay for the sick. The Robert Wood Johnson Foundation and the Urban Institute have come to largely the same conclusion—enrolling a total of 10 million in the exchanges, based on historic trends, would mean only about 9 million of them would be subsidy eligible. That would amount to only 38% of the 24 million people eligible for a subsidy.
The Urban Institute’s Robert D. Reischauer and Brookings Senior Fellow Alice M. Rivlin highlight three main health care issues the candidates should focus on that are likely to dominate the election debate. Republicans must form consensus around a replacement plan for the Affordable Care Act and Democrats must develop ways to improve the law. Both must focus on how to control rising health spending and how to preserve Medicare for the growing elderly population.
One of the untold elements of the rapid decay underway in the ObamaCare exchanges is the massive shift toward the Medicaid managed care companies, and away from the traditional commercial insurers like UnitedHealth Group and Aetna. In short order, ObamaCare is evolving into a Medicaid marketplace. Not only in terms of the design and quality of the narrow-network plans that are being offered, but in the actual carriers that sell those policies.
The new individual marketplace created under ObamaCare was intended to rival that of the employer sponsored insurance marketplace in stability and predictability, while premiums were to rise at rates much lower than the historical average. This study from the American Action Forum evaluates the degree to which these promises have been fulfilled. AAF found that the cost of both the benchmark Silver plan and the lowest cost Bronze plan will increase by 10% in 2016.
High-deductibles are problematic insofar as markets for health care services are dysfunctional. Fixing those markets should be a priority. An important element here that’s often ignored, however, is the physician or hospital. Much of the focus on price and quality transparency looks to insurers and other tools that patients can use before ever interacting with the health care system. This is very important. A patient looking to schedule a surgery, looking for a new physician, or trying to fill a prescription should have access to cost and quality information that allows for informed decisions.
UnitedHealth expects to lose $425 million on ObamaCare, including $275 million in 2016. The situation is so dire, the company took the unusual step of announcing between quarterly reports both the losses and that it may withdraw from Obamacare entirely after 2016. If United indeed pulls out, it would cause hundreds of thousands more Americans to lose their health plans.