Administration officials say fewer insurers filing an intent to offer coverage for 2018 shows the ACA is failing.
As Congress weighs the future of the Affordable Care Act (ACA), CMS on Monday announced a 38% drop in the number of insurers seeking sell policies on federal exchanges for 2018. The exchanges serve 39 states, accessed through HealthCare.gov.
“This is further proof tha the Affordable Care Act is failing,” CMS Administrator Seema Verma said in a statement. “Insurers continue to flee the exchanges, causing Americans to lose their choice for health insurance or lose their coverage all together.
The number of insurers making submissions for individual market qualified health plans was 141, down from 227 at this point a year ago. Only 167 ultimately followed through to open enrollment, following the exodus of UnitedHealthcare and Aetna’s contraction from all but a few markets. A judge later said Aetna’s move was clearly tied to a Department of Justice decision to oppose its merger with Humana. Aetna will completely stop writing ACA coverage for 2018.
The drop was anticipated, as CMS had previously released a map in late June showing counties that it forecast will have just 1 insurer in 2018. CMS, which oversees the ACA, as well as Medicare and Medicaid, predicted that 49 counties will not have an ACA insurer. Most of the counties with no ACA insurers or only 1 were in the South or Midwest.
The House and Senate have weighed competing bills to repeal or replace the ACA. A bill has passed the House, but no vote is scheduled in the Senate. Some senators say their bill does not do enough to repeal the ACA and lower premiums while others say cuts to Medicaid are too steep.
Meanwhile, the Trump administration has been unclear whether it will continue the subsidies that insurers say are essential to making ACA plans work. In May, after weeks of signaling it might cancel the subsidies, the administration delayed for 90 days a final call on whether to appeal a court ruling that seeks to end them.
While administration officials say the drop is proof that the ACA is failing, the law’s supporters insist Trump and his appointees have purposely created uncertainty to scare away insurers. Companies have until September to make a final decision on selling coverage for 2018.
In letter to Senate Majority Leader Mitch McConnell, R-Kentucky, Minority Leader Chuck Schumer, D-New York, and 3 colleagues called on Republicans to work with Democrats to “provide stability and certainty to the health insurance markets.”
Real-World Study Reveals Key Insights into DLBCL Treatment Patterns, Outcomes
April 18th 2024A recent study offers valuable insights into the characteristics, treatment patterns, and outcomes of diffuse large B-cell lymphoma (DLBCL) in patients across different lines of therapy, providing a look into the landscape of DLBCL management.
Read More
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
Listen
Collecting SDOH Data Can Assess Risk of Medical Nonadherence, Improve HEI and Star Ratings
April 18th 2024At the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting, a panel of presenters explored changes coming to Medicare that incorporate social determinants of health (SDOH) data to improve patient and health system outcomes.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.
Read More
Commonwealth Fund Report Details Pervasive Racial and Ethnic Disparities in US Health Care, Outcomes
April 18th 2024Using 25 health system performance indicators, the Commonwealth Fund 2024 State Health Disparities Report evaluated racial and ethnic disparities in health care and health outcomes both within and across US states and highlighted the urgent need for equitable health care policies and practices in the US.
Read More