Risk Adjustments in ObamaCare

[somarco]

It is conceivable the only players for 2017 will be off exchange. Wouldn't that be a hoot?

 

[russelltw]

Cannot imagine any staying on or off exchange. We have 3 carriers on exchange in NC. If one pulls out, the other two will be quick to follow.

There are about 1/3 of the counties that have all 3 carriers. The other 2/3 have either 2 or only 1 carrier (being UHC and BCBSNC). If either of those two pulls out, cannot imagine the other staying to take all the others, so the second carrier would pull out. That would leave Aetna/coventry being the only carrier in 1/3 of the counties, and I can imagine they would not want everyone in those counties.

It would be dominoes falling...

 

[somarco]

My reason for suggesting some may not write HIX business is the difficulty in trying to get everything from hc.gov, reimbursement, etc.

Plus the reports that say HIX business doesn't stick around as long as off-HIX business and HIX has a much higher LR

 

[HealthRisk]

Then its nothing but the government taking insurers money. Collect it from them, take half a billion dollars for yourself, and give the remaining amount back. I think Uncle Sam got this laundering scheme from Bernie Madoff.

The fun part is this didn't come just from insurers. The fee was assessed on all health policies, including even ASO employers. Those folks on self-funded plans that thought they were immune to ACA, not so much.

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Not likely, just the opposite since reinsurance goes away in 2017.

In truth, this is one of the more stable elements to deal with, so carriers can account for it in setting 2017 rates. So this specific item should not keep any carrier in or out.

Spot on. The wear off of reinsurance is going to provide substantial rate increases in the individual market, above whatever poor financial results are already driving rates higher.

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Thank-you for answering that question, ActuaryGuy. It will be interesting to see which carriers return for more guaranteed financial losses in 2017.

2017 actually simplifies things. The only R left is risk adjustment. Carriers will have to price for their own costs and adjust only for riskiness of their pool. There is no backstop from risk corridors, which removes some of the moral hazard to price low.

 

[unic.consulting]

It took Massachusetts 7-10 years to get everything figured out. And that was without groups trying to make it more difficult.

 

[somarco]

took Massachusetts 7-10 years to get everything figured out

Didn't MA get a lot of federal tax dollars to help fund their experiment?

https://www.washingtonpost.com/news/wonk/wp/2012/09/21/how-romney-paid-for-romneycare/

Lessons from the Fall of RomneyCare | Cato Institute

Obamacare won't last that long and no one to bail it out.

 

[RayNY]

The fun part is this didn't come just from insurers. The fee was assessed on all health policies, including even ASO employers. Those folks on self-funded plans that thought they were immune to ACA, not so much.

More accurately, it was a tax levied on all policyholders.

Policyholders ultimately paid the tax, health plan issuers were just a flow-through from policyholder to gov't. It was an additional cost tacked onto premium.

 

[HealthRisk]

More accurately, it was a tax levied on all policyholders.

Policyholders ultimately paid the tax, health plan issuers were just a flow-through from policyholder to gov't. It was an additional cost tacked onto premium.

It was a fee.

 

[RayNY]

It was a fee.

Next you're going to tell me that hookers are "companions" and you make a "donation" for their time.