Dive Brief:
- While UnitedHealthcare has drawn much attention with its decision to exit most of its ACA marketplaces in 2017, most insurers actually plan to stay the course or even expand their participation, according to an analysis by The Commonwealth Fund.
- In pursuit of a broader perspective on insurer strategy, researchers reviewed first-quarter earnings calls and regulatory filings from major publicly traded insurers participating in the marketplaces, including Aetna, Anthem, Centene, Cigna, Humana, Molina and United.
- They found only Humana also explicitly discussed leaving some markets, while "most of the large, publicly traded insurers remain committed to the marketplaces."
Dive Insight:
The findings indicated that significant early losses are not dissuading most insurers, who continue to see opportunity in the ACA marketplaces and are adapting by adjusting their products and premiums. As a result, the analysis found ACA marketplace insurer participation stable and concluded "the insurance industry doesn’t have a monolithic perspective on the marketplaces."
The majority of participating insurers have continued to tell investors they see value in the marketplaces and that they are well-positioned to grow their ACA business over time, the researchers found. Several insurers reminded stakeholders it could take several years to see profitability. For example, researchers quoted Molina noting, “We have never expected our marketplace product to perform better than our Medicaid business, nor operate at significantly better margins over the long term.”
The analysis also noted that insurers are seeing mixed results in their risk pools, with some healthier than others, and that several have continued to address challenges to their marketplace business with proposed changes regarding requirements around plan design, adjustments to the ACA’s risk-adjustment program, and tougher standards for special enrollment qualification.