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.
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.
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.
This high incidence of failure teaches us two things. First, it should end the thinking that non-profits are somehow better than for-profits. The second lesson is for Republicans in Congress. While there are major problems with Obamacare that should be addressed, legislators shouldn’t throw away the baby with the bathwater.
When consumer advocates tried to call the obstetrician-gynecologists in the online directory of insurers’ in-network providers on the Maryland state exchange, they found that only about 22% of the 1,493 practitioners were accepting new patients, performed well-patient visits and had appointments available within four weeks. More than a third weren’t available at all because they had left the networks, retired or were dead.
There are 499 markets for Obamacare plans in the United States. In 89 of them, the insurance company that offered this year’s best deal in the “silver” category will not be returning for 2016. The New York Times has created an interactive map showing in what areas of the United States this is the case.
For a snapshot of typical insurance prices for 2016 under the health law, The Wall Street Journal examined choices for a midrange “silver” plan through HealthCare.gov for people who currently have coverage with the most popular insurer in their state. Premiums for plans that have been the most popular in each state are rising by double-digit percentages in 20 of the state capitals’ counties, and by more modest amounts in 10 others, the Journal found.
For many consumers, switching health insurance plans has become an unwelcome ritual, akin to filing taxes, that is time-consuming and can entail searching for new doctors and hospitals each year. Gail Galen, 63, is preparing to leap to her third insurer in three years as she braces for another round of shopping on the federal insurance marketplace. “Every year I feel like I’m starting all over again, and I just dread it,” said Galen. “My stress level just shoots up.”
When the Patient Protection a
nd Affordable Care Act (ACA) was signed into law in 2010, many groups projected how many people would enroll in health insurance plans satisfying the law’s new rules and requirements (ACA plans). Nearly six years later, enrollment in health insurance exchange plans is far short of initial projections, particularly for people who earn too much to qualify for subsidies to reduce high ACA plan deductibles. The dearth of exchange enrollees with at least a middle-class income indicates that the individual mandate is not motivating as many people, particularly younger, healthier, and wealthier people, to purchase coverage as was originally expected. Large insurer losses on ACA plans show that the overall risk pool is sicker and much more costly than originally projected, and are an indication that the law may require significant revision in order to avoid causing an adverse-selection spiral.