Large health insurers have joined the parade of startups investing more in marketing and operations to expand their geographic footprints and sell more individual coverage under the Affordable Care Act.
Anthem, the nation’s second-largest health insurer, said last week its performance has improved from last year when losses triggered a major retreat from Obamacare. So much so, Anthem last week said the number of individual customers dropped by more than 1 million to 712,000 in the second quarter compared to last year.
But Anthem executives say the insurer’s ACA individual business has stabilized enough that the operator of Blue Cross and Blue Plans in 14 states will expand in 2019 near areas where it still offers Obamacare coverage. It didn’t specify what states would see expansions, executives said in an update last week during Anthem’s second quarter earnings call.
“I think you’ll see some county expansions,” Anthem CEO Gail Boudreax said of 2019 plans for the ACA’s exchanges . “But I think more focused on the areas that we’ve been this year. So not a major rescaling, but we are pleased with the performance.”
The decision by Anthem is the latest sign that health insurance companies are forging ahead with expansion plans despite verbal and financial attacks on Obamacare by the Trump administration… Read More at Forbes
When the Trump administration announced a few weeks ago that it would freeze important Obamacare payments to health insurers, it wasn’t clear whether it was once again trying to sabotage the law, or needlessly introducing uncertainty to the law’s insurance markets, or both, or maybe neither.
Whatever it was, the Health and Human Services Department took action Tuesday to fix the problem, get the money flowing again, and remove any unnecessary doubt for insurers over billions of dollars in payments they were expecting.
At stake was Obamacare’s “risk adjustment” program. In brief, the program tries to help balance the medical risk in the law’s insurance markets. Health insurers that are found to have healthier customers (according to a federal formula) pay money into the program, and then insurers who have sicker customers receive money out of it… Read More at Vox
The failure of the GOP health care plan in Congress and the ongoing uncertainty surrounding the Trump administration’s next moves have left insurers skittish about participating in the Obamacare exchanges next year. And this could leave hundreds of thousands of Americans without an option for subsidized coverage.
An emerging, even challenging aspect of Obamacare it may well be, according to The Los Angeles Times (Michael Hiltzik – online 5/8) “holding insurance companies to their promises and obligations to keep their networks adequate – – and to keep them from lying about the availability of doctors.”
Hiltzik’s L.A. Times Article explains, “One of the most controversial and least understood aspects of coverage under the Affordable Care Act is the network concept. More precisely, the narrow-network concept, since the whole goal of health insurers that steer patients to networks of preferred doctors and hospitals is to keep the provider roster limited and therefore (so they expect) cheaper.”
But, do these “networks” cater to patients adequately? The Times report also asks: