Insurers' margins on individual insurance plans improved in aggregate in 2016 over 2015. But their losses still totaled billions of dollars.
While some health insurers are bailing on the Affordable Care Act exchanges, other are swooping in to take the business they leave behind.
Senate Republicans' bill to repeal and replace the Affordable Care Act may be enough to keep insurers from exiting the exchanges in 2018. But Medicaid insurers warn the bill's caps on federal spending in that program would compel them to cut services and reduce provider reimbursement rates.
While many insurers are retreating from the individual insurance market, Oscar thinks its tech-driven insurance products and concierge-style member experience will help the company thrive in a time of regulatory uncertainty.
Insurers must say Wednesday whether they plan to sell coverage on the Affordable Care Act's insurance exchanges next year. The deadline is the first look at the state of the federal marketplace for 2018: how much rates could go up and which counties are at risk of having no insurers.
Medica said Thursday that it will offer plans on Nebraska's exchanges statewide in 2018. The Minnetonka, Minn.-based insurer will be the only participant in the state.
Despite the instability of the individual market, Cleveland Clinic and Oscar are betting that a narrow network plan focused on keeping patients out of the hospital with help from care coordinators will keep their product afloat.
The CMS will not expand a pilot that let consumers see how many providers were offered on plans purchased on HealthCare.gov. The pilot will remain targeted to Maine, Ohio, Tennessee and Texas.
Health insurer Centene announced plans Tuesday to expand into more Affordable Care Act insurance exchanges for next year, at a time when competitors are either pulling back from those markets or proposing steep price hikes to remain.
Medicaid expansion, cost-sharing subsidies and a big marketing budget are keys to the state's success. Two of those ingredients are in jeopardy of being nixed or rolled back under the House Republicans' bill to repeal the Affordable Care Act now being revised in the Senate.
The CMS' exit survey data show the bulk of dropouts obtained employer-sponsored coverage. A second agency report showed that consumers who dropped off the insurance rolls had higher premiums than most due to less financial assistance from the federal government.
Policy experts worry new that policies set for gaining coverage during special enrollment periods on the individual marketplace will affect the Affordable Care Act's exchanges.