Risk corridor data released on October 1 by the administration shows that insurers lost a lot of money on Affordable Care Act (ACA) plans in 2014. The ACA established a three-year risk corridor program to transfer funds from insurers with lower-than-expected medical claims on ACA plans, i.e., profitable insurers, to insurers with higher-than-expected claims, i.e., insurers with losses. Despite administration claims that incoming payments from profitable insurers would cover losses from unprofitable ones, the risk corridor program shortfall exceeded $2.5 billion in 2014. Insurers with lower-than-anticipated claims owed about $360 million, and insurers with higher-than-anticipated claims requested about $2.9 billion from the program.
Stephanie Douglas signed up for health insurance in January with the best intentions. She had suffered a stroke and needed help paying for her medicines and care. The plan she chose from the federal insurance exchange sounded affordable — $58.17 a month after the subsidy she received under the Affordable Care Act.
But Ms. Douglas, 50, who was working about 30 hours a week as a dollar store cashier and a services coordinator at an apartment complex for older adults, soon realized that her insurance did not fit in her tight monthly budget. She stopped paying her premiums in April and lost her coverage a few months later.
The two largest state health insurance co-operatives created as part of a grand ObamaCare experiment have announced they are closing at the end of this year, joining others that have failed and even more that are insolvent and likely to fail.
The Kentucky Health Cooperative announced on Friday it is going out of business and will not enroll new members next year, leaving 51,000 members to find other coverage. It had the second-largest co-op enrollment in the country, garnering 75% of people who enrolled in coverage through the state’s health exchange.
The largest private provider of health insurance policies on Kynect, Kentucky’s health insurance exchange, is going out of business.
The Louisville-based Kentucky Health Cooperative Inc. announced Friday that it will end current memberships on Dec. 31 and will not add new members because of financial problems. It will not offer health insurance plans on Kynect when open enrollment for 2016 coverage starts on Nov. 1.
One of the least-reported substantial policy victories in recent years was stopping Obamacare’s insurer bailout through last fall’s CRomnibus bill. Now we can attach a price-tag to that victory: $2.5 billion. That’s how much taxpayers would have been funneling to President Obama’s insurance-company allies if the bailout hadn’t been thwarted, according to Obama administration officials. Insurers were hoping for $2.87 billion but, thanks to the anti-bailout legislation, which required Obamacare’s risk-corridor program to operate in a revenue-neutral manner, rather than as a bailout, they will be getting only $362 million—the same amount that other insurers paid in.
The health insurance Marketplaces created under the Affordable Care Act have attracted nearly ten million enrollees, including many people who were previously insured by an employer-sponsored plan. The most popular Marketplace plan—the silver plan—has significantly higher cost sharing than does a typical employer-sponsored plan, which may cause patients to reduce the use of cost-saving services that are essential for managing chronic conditions.
Chronically ill people enrolled in individual health plans sold on the Affordable Care Act insurance exchanges pay on average twice as much out-of-pocket for prescription drugs each year than people covered through their workplace, according to a study published Monday in the Health Affairs journal.
Health insurers will lose about $2.5 billion because patients covered through President Barack Obama’s health law last year were sicker than expected, according to government figures released late Thursday.
The Department of Health and Human Services released updated numbers for a program that helps stabilize premiums in the health care law’s insurance markets, which offer taxpayer-subsidized private plans. Under that program, insurers whose medical claims costs were lower than expected pay in money to help insurers whose costs were higher.
Lackluster enrollment numbers, technology issues, and high maintenance costs are among the challenges plaguing ObamaCare state exchanges that were reviewed by the House Energy and Commerce Oversight Subcommittee at a hearing Tuesday.
“CMS has seemed more focused on doling out taxpayer dollars rather than overseeing how those dollars are spent,” Chairman Tim Murphy (R-PA) said of the lack of oversight.
Executives from six state exchanges—Oregon, Massachusetts, Hawaii, California, Minnesota, and Connecticut—provided testimony. So far, Oregon and Hawaii’s exchanges have both proven to be unsustainable, closing down and migrating consumers to HealthCare.gov’s federal marketplace with others likely to follow.
Chairman Murphy emphasized in his opening statement the sufficient amount of taxpayer money that was poured into creating these now-failing exchanges: “The Centers for Medicaid and Medicare Services has awarded $5.51 billion dollars to the States to help them establish their exchanges. Let me repeat that. The States received $5.51 billion in federal taxpayer dollars to set up their own exchanges. Yet, the ACA had no specific definition of what a state exchange was supposed to do, or more importantly, what it was not supposed to do.”
Grant money used to fund the exchanges was cut off in 2015 when states were expected to start bringing in enough money to continue operation on their own. Of the 17 states that chose to establish their own exchanges, nearly half face financial difficulties.
The committee hopes to find out why exchanges have struggled to become self-sustaining and whether or not any grant money will be recouped from states where exchanges have been shut down. For instance, Oregon spent $305 million of taxpayer dollars to establish its failed exchange, while Hawaii spent $205 million.
As Americans for Tax Reform points out, Tuesday’s hearing is a vital first step to addressing the urgent problems within the state exchanges—before they spread to all 17.
Bad news for New Yorkers, thanks to ObamaCare: More than 100,000 policyholders just learned that their Health Republic insurance plans will be canceled on Dec. 31. The start-up insurer (spun off from the Freelancers’ Union) is hemorrhaging red ink and has to close down.
That’s unfortunate for the policyholders, who now have to scramble to find other coverage and try to keep their doctors.