An analysis from the Kaiser Family Foundation of the 2017 financial performance of health insurers found that last year was their best year selling individual-market health insurance since the Affordable Care Act was put into place, even without the cost-sharing subsidies that they lost in the fourth quarter.
An analysis from the Kaiser Family Foundation (KFF) of the 2017 financial performance of health insurers found that last year was their best year selling individual-market health insurance since the Affordable Care Act (ACA) was put into place, even without the cost-sharing subsidies that they lost in the fourth quarter.
The findings suggest that insurers, on average, priced their plans adequately last year, the report said. The analysis is based on insurer-reported financial data, including information from the National Association of Insurance Commissioners.
KFF used 2 different financial indicators to come up with their findings:
In addition, premiums per enrollee grew 22% from 2016 to 2017, while per person claims grew only 5%, further helping profitability.
The ACA required insurers to guarantee access to coverage for patients with pre-existing conditions and cover those conditions in the early years of the law in 2014 and 2015. Previously, before the ACA, insurers could excude coverage and services for people with pre-existing conditions, which was a less expensive way of doing business.
KFF said 2018 and 2019 presents new challenges, given changes made during recent months by the Trump administration, including:
KFF said these changes and political uncertainties are driving up premiums and potentially pricing out healthy consumers.
It is likely that insurers would generally have required only modest premium increases in 2018 and in 2019 as well if the administration had not made these changes, KFF claimed. Insurers are looking to file proposed rates for 2019, and in some parts of the country, individual markets are fragile, with little competition and an insufficient number of healthy enrollees to balance out the unhealthy.