by Jacqueline Renfrow | Jun 4, 2019 8:28am
Insurance
companies plan to up their number of Affordable Care Act (ACA) plans available
in 2020, according to eHealth’s latest survey (PDF) of health insurance companies
on enrollment trends.
As of
May, 45% of insurers said they intend to add to the number of ACA plans they
will offer in 2020, compared to 21% who added plans for 2019. Overall, 60% said
they plan to "broaden" their participation in the markets next year.
So why
expand? A majority, 78%, said expansion aligns with the overall company
mission; 44% said because the market has stabilized; and 33% intend to expand
because the ACA market has become profitable for their company.
"Insurers
that have stayed in the ACA market have generally found a way to be profitable.
I think our survey suggests they expect a certain amount of stability in the
market for the foreseeable future, giving them confidence to consider modest
expansions in their product offerings," an eHealth spokesperson told
FierceHealthcare.
Also,
42% of insurers expect to raise premiums between 5% and 10% over 2019, 23%
don’t expect to make changes to premiums and 23% expect to reduce monthly
premiums by 5% or more.
Most
insurers surveyed said that the ACA’s last open enrollment period had
predictable sales, while 15% said sales outpaced expectations by 10% to 15% and
another 15% said sales were 10% or more below expectations.
More
than half, 58%, of insurers do not intend to make changes to out-of-pocket
expenses in their 2020 ACA plans; 17% will increase deductibles by 10% or less;
and 17% will increase deductibles by more than 10%.
Also,
about 67% of respondents said that elimination of the ACA tax penalty has had no
major impact on member retention, but another 33% said they did lose members as
a result.
In
addition, Most insurers predict instability and higher premiums for older,
sicker consumers if Texas vs. Azar is upheld (82%). A
quarter said they would expand their presence in the market as a result of the
higher premiums, and 6% said they would leave the individual and family market
entirely
So
unless there is an appeal, 82% of respondents said Texas vs. Azar will not
affect their plans already in place for 2020.
Most
insurers also don’t expect to see the fruition of "Medicare for All"
anytime soon. About 24% said this is a political issue that they are not taking
seriously, up from 7% in 2018. Only 6% believed big changes to Medicare are
possible in the future, compared to 27% in 2018.
"Barring
any political or policy upheavals, it seems that the ACA market has found a
point of relative equilibrium, and that we’re unlikely to see major insurer
withdrawals from the market in the near term," the eHealth spokesperson
added. "There may also be more plans for consumers to choose from during
the next open enrollment period. That said, it’s still a tough market for
middle-income folks who earn just a bit too much to qualify for government
subsidies. As we reported some time ago, the average monthly premium for
unsubsidized individuals buying ACA coverage on their own for 2019 is $448 per
month, while the average for family coverage is $1,154 per month—that’s nearly
$14,000 a year in premiums alone (not counting deductibles and copays) for the
average family. Unfortunately, many people who do not qualify for subsidies are
finding themselves priced out of this market."
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