How Healthy Are Obamacare Insurance Markets?

Aug 10, 2017


WASHINGTON - Critics charge that the Obamacare marketplaces are imploding, but federal data says otherwise.

One measure shows that current premiums are bringing in well more than enough to pay for claims, on average. Another, which looks at the mix of healthy to sick customers in the insurance exchanges, shows stability for 2016 and early 2017.

Andy Slavitt is the former acting administrator of the Centers for Medicare and Medicaid Services. He said if the White House were not trying to undermine the Affordable Care Act, most exchanges would be fine.

"Given that this is a profitable market, absent this action by the Trump administration, you would be seeing insurers expand," Slavitt said. Critics of the ACA say costs are spiking and choices are disappearing. But Slavitt said after some turbulence in 2014 and 2015, the markets' fundamentals are "healthy and profitable."

One central argument for repealing Obamacare is that some exchanges offer only one insurance plan, or have none to offer at all. Mario Molina, the former CEO of Molina Healthcare, said only 0.1 percent of counties - with a total of about 10,000 residents - have no plan. And he said that is a problem. But, Molina said, attempts to repeal the ACA are causing confusion and instability. He said that's what's driving some insurers away. "It's the policies and the debate that are scaring off the insurance companies," Molina said. "We've seen a number of large insurers withdraw simply because it's not a big part of their business, and they're not willing to put up with the instability around this."

According to Slavitt, many of those counties are rural, with a lot of health care problems that predate the ACA. "In many rural parts of this country, it's not just that there are very few health plans, there's very few hospital systems and very few physician offices," Slavitt said. "There's just too few people that live there." Since the failure of repeal bills in the Senate, debate on health care in Congress has quieted considerably. A bipartisan group in the House is pushing for more moderate reform.

More on the health of the ACA markets is available here.