The Individual Market May Have Shrunk, But More And More Insurers Are Banking On Health Law’s Profits
Many big insurers are planning bigger footprints in the exchanges for next year despite all the political and legal uncertainty still surrounding the health law. In other health insurance and industry news: the quality of coverage from insurers offering ACA plans, the financial effects of public ire over high health prices, premiums that are leveling off, and more.
The Wall Street Journal:
Health Insurers Set To Expand Offerings Under The ACA
Insurers are expanding their Affordable Care Act plan offerings for next year, with the once-troubled business now generating profits, even as the overall individual-insurance market has shrunk. Oscar Insurance Corp. is the latest to announce its expected growth for 2020, adding six new states, including Pennsylvania and Georgia, to its current roster of nine. Insurers including Cigna Corp. , Bright Health Inc., Molina Healthcare Inc. and Centene Corp. , the biggest seller of ACA plans, also plan larger footprints next year. Anthem Inc. is expanding in at least two of its states, California and Virginia. (Wilde Mathews, 8/22)
Houston Chronicle:
Oscar Insurance To Enter Houston ACA Market In 2020
Oscar, a fast-growing, tech-based insurance start-up, will offer individual plans for 2020 through the Affordable Care Act's exchange for the first time in Houston, the company said Thursday. The New York insurer already has an established footprint in Texas with 60,000 members-- nearly a quarter of its overall national membership. It sells individual plans on the exchange in Austin, Dallas-Fort Worth, El Paso and San Antonio but has been absent from Houston. (Deam, 8/22)
Atlanta Journal-Constitution:
Anthem/Blue Cross Individual Plans Won’t Have WellStar Next Year
WellStar patients in northwest Atlanta who had Anthem individual insurance policies through the Affordable Care Act will likely have two alternatives to get their care covered in 2020. But Anthem won’t be one of them. WellStar, by far the dominant health care provider in Cobb County, told the Atlanta Journal-Constitution Thursday that it had been unable to come to terms with Anthem after the carrier shocked its individual customers this year by dropping WellStar from their network. (Hart, 8/22)
Modern Healthcare:
Some Major Exchange Insurers Come Up Short On Quality Scores
Newly published data from the federal government shows that some of the health insurers enrolling the most people in coverage on the Affordable Care Act insurance exchanges have quality ratings below the national average. Most 2019 exchange plans, or about 64% of 195 plans listed in the CMS data, received an overall quality rating of four or five stars, with five being the highest rating, according to Modern Healthcare's analysis of CMS data released last week. Another 26.2% of plans received a 3-star rating. The rest—about 10 health plans—received a 1- or 2-star rating. (Livingston, 8/22)
The Wall Street Journal:
Social Issues Weigh On Health-Care Companies, Credit Raters Warn
Social issues are increasingly weighing on the credit ratings of American health-care companies. S&P Global Ratings, Moody’s Corp. (MCO) and Fitch Ratings Inc. warn that mounting public pressure to cut medical costs has recently threatened the industry’s credit amid a renewed political debate on drug pricing and national health insurance. For instance, health-care companies are under pressure from insurers to lower costs as Medicare patient volumes have surged against commercial patients, said Andrew Steel, global head of sustainable finance at Fitch Ratings Inc. (Holger, 8/22)
CQ:
Insurance Rate Hikes Cool As Reinsurance, Stability Increase
Health insurance premiums on the exchanges are leveling off as policy action fades and as more states establish reinsurance programs to keep costs in line. Colorado, Delaware, Montana and North Dakota all received the green light from the Centers for Medicare and Medicaid Services this year to subsidize high-cost claims that fall within a preset dollar amount, ranging from a minimum of $30,000 to a maximum of $1 million. Rhode Island is also awaiting approval for a reinsurance waiver the state applied for in June. (Clason, 8/22)
Georgia Health News:
Don’t Confuse Care Sharing Ministries With Insurance, State Warns
Georgia’s insurance commissioner is warning consumers of the potential financial risks of joining a Health Care Sharing Ministries program as an alternative to regular insurance. In these organizations, members agree to share one another’s health care costs. Members of an HCSM typically have a particular religious faith in common, and make monthly payments to cover expenses of other members. (Miller, 8/22)
