Wednesday, September 25, 2019

Building on ACA Is Likely the Most Insurer-Friendly Health Care Reform Option

As it's becoming clearer that the Affordable Care Act has done as much as it can to reduce the U.S. uninsured rate, "policy risk may be increasing rather than decreasing" for health insurers amid a growing appetite for greater health care reform.
That's the conclusion of a recent report from Standard & Poor's (S&P) analysts. One of those analysts, Deep Banerjee, tells AIS Health that the best-case scenario for the managed care sector would be for policymakers to build upon the ACA.
Fixing the ACA — an effort that mainly would involve expanding government subsidies to a larger swath of individual market enrollees — would have a positive impact on consumers' out-of-pocket expenses, the insured rate and health insurers' credit quality, the report says.
If health care reform took the form of a single-payer system without private insurance, the S&P report deems it "extremely negative" for insurers' credit quality. The same would be true if higher courts uphold a ruling in a Texas-led court case that seeks to repeal the ACA.
Under all of the possible paths the policy framework could take, "insurers' ability to manage through the policy uncertainty will be key to their credit in the next few years," according to S&P. When asked what steps insurers are taking to be adaptable, Banerjee says that "one is obviously [to] look at where there is a clear growth area that has the least amount of policy debate — and that is Medicare Advantage."
Then there's mergers and acquisitions, which increasingly focus on joining forces with "intermediaries" in the system like PBMs, or with non-hospital health care providers, he says.
Finally, the individual insurance market offers a prime example of insurers' adaptability, as it's undergone a complete turnaround from its early years marked by significant insurer losses and subsequent market exits, according to Banerjee.
From Health Plan Weekly

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