by Leslie Small
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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