Hsiu Mei Wong, US innovation lead at PA Consulting, discusses the annual open enrollment period to sign up for a 2019 health insurance plan through the US federal health exchange.
News last week that Oscar Health filed a federal lawsuit accusing Florida Blue of a “monopoly” in selling individual health coverage under the Affordable Care Act is the latest signal that Obamacare is here to stay. Florida is one of the many new markets Oscar is selling individual healthcare coverage under the Affordable Care Act for benefits that would begin in January 2019. Aggressive marketing and related business sales practices are a new one this year for Obamacare.
Hsiu Mei says: “Insurers are competing aggressively for business as many have made investments that will bolster margins, and therefore it is a membership acquisition numbers game.”
Across the country, more insurers are participating in the ACA’s insurance exchanges with 608 counties “gaining at least one insurer in the marketplace, while only five counties will lose an insurer,” the Kaiser Family Foundation said in a new report last week. The report comes as Americans are choosing their coverage under the ACA for 2019. Open enrollment ends Dec. 15.
Those signing up for 2019 coverage are finding far more choices than two years ago when Aetna, Anthem, Humana and UnitedHealth Group scaled back or left the Obamacare business entirely because they were unable to effectively manage the costs of sick patients signing up for coverage.
But those that have stayed in the business since individual coverage was first offered on the ACA’s exchanges six years ago say one key is to understand their market. UnitedHealth, Aetna and Humana were less familiar with the individual business before they offered plans on exchanges whereas Blue Cross plans like Florida Blue have been in the individual insurance business consistently for decades.
Other national players like Oscar, Bright Health and Centene have expanded gradually in the ACA's individual business. Centene is now the largest player in the Obamacare business with more than 1.5 million enrollees and has expanded to 20 states for 2019.
There’s no doubt that carriers that have remained have benefitted from large price increases though industry analysts say they’ve also invested in healthcare coordination to help better manage a population that didn’t have coverage before and had a pent up need for medical treatment.
Hsiu Mei adds: “Over the last six years they learned from the market and now have a better understanding of the on-exchange market and have honed models to price for risk. Insurers have invested in care programs to achieve better outcomes for members and better manage their medical costs. Some have heavily invested in enterprise capabilities like technology which has further lowered the cost of doing business.”
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