Dive Brief:
- Kaiser Permanente, a $61 billion health system, will "absolutely" be remaining in the ACA exchanges "for the long haul," Bernard Tyson, the company's CEO, recently told Modern Healthcare.
- His support for the exchanges is associated with the "slight margin" Kaiser has made on its ACA plans.
- Kaiser's verbal commitment comes days after Aetna announced it will be dropping out of most of the exchanges, following a string of dropouts from other insurers citing substantial marketplace losses
Dive Insight:
Insurers, including Aetna and Humana, have been facing financial losses of about hundreds of millions of dollars on the exchanges. These have been attributed to in part by sicker-than-anticipated patients and a lack of risk-corridor funding, which was supposed to have provided financial support during the ACA market's early years.
However, some health insurers like Molina Healthcare, Florida Blue, Centene and Kaiser have found ways to make some money with ACA plans. Narrow provider networks, Medicaid expansion, and high deductibles have led in part to their profitability. Florida Blue CEO Patrick Geraghty said earlier this week the company has succeeded because it knows the Florida market "intimately well."
“The idea that I would turn my back on a segment of the American population who really needs the coverage and the care—I'm in for the long haul,” Tyson told Modern Healthcare. “And I'm cautiously optimistic that at some point, we begin to make sure we have the right regulations, meaning oversight, to make sure the market is behaving like it was intended.”
Kaiser has an advantage over many other insurers due to the ACA's transitional reinsurance program for which the company received $194 million, according to a CMS report released in June.