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Wednesday, Jun 6 2018

Full Issue

These Insurers Don't Expect Members To Drop Plans After Mandate Repeal. So Why Are Their Premiums Still Spiking?

It comes down to the "cascade phenomenon," insurers say. Even if a smaller company doesn't expect to lose members, it will still feel the pain from the changes in the industry because of how the health law has tied the marketplace together with the permanent risk adjustment program.

Even health insurers that don't expect many of their plan members to drop insurance coverage after the individual mandate penalty is zeroed out still may have to raise individual market premiums in 2019 as their payments from the ACA's risk adjustment program change thanks to the mandate loss. Buffalo, N.Y.-based insurer Independent Health doesn't expect a large number of its 5,000 ACA exchange members to drop their coverage when the individual mandate penalty is effectively repealed starting in 2019. Its population skews older and sicker, and most members need their insurance coverage. Its average member is about 49 years old, and about half receive federal premium subsidies. (Livingston, 6/5)

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