By More than 10.3 million Americans purchase health insurance through the Marketplace that was created by the Affordable Care Act. And while insurers were quick to jump in and provide coverage in 2010, they have since been exiting the market at a rapid clip. Insurers tend to shy away from coverage in rural America as it is harder to make a profit due to a smaller and older customer base. Rural areas also tend to have a dominant care provider like a hospital system which can make it difficult to negotiate payment rates.
Earlier this year, more than 40 counties (mostly rural) faced the prospect of having no insurance options for the 2018 marketplace exchange. Insurers have slowly stepped up to offer coverage, and the last county in the US, Paulding County (Ohio), has found a provider for the exchange. The marketplace is important to many Americans as it allows them to purchase subsidized health care.
Why insurers are leaving the marketplace
Over the years, insurers have been exiting the marketplace citing heavy losses. Even though all Americans are required to have medical coverage or pay a penalty, there are not enough young, healthy customers purchasing through the exchange to balance out the claims.
This year in Ohio, 20 of 88 counties were at risk of not having an insurance provider in the marketplace. Ohio State Insurance Director Jillian Froment has made it a staff priority to find insurers to fill in the gaps in the marketplace in recent weeks.
The possible end of a federal cost-sharing program is also causing insurers to panic. The federal government provides billions of dollars to insurers to cover cost-sharing reductions for customers with modest incomes. These payments reimburse insurers for lowering deductibles and out of pocket expenses for customers. They are separate from income-based tax credits that help people buy coverage and President Trump has repeatedly threatened to end them. Insurers expect premiums to soar for some of their plans if this happens.
Future Unknown
The future of the marketplace is still unknown as Congress works to repeal the Affordable Care Act and come up with something to replace it. Insurers have the next 30 days to finalize their market coverage for 2018 before open enrollment begins Nov 1. Take Command Health is keeping a close eye on the market and tracking changes to health laws that affect our customers. As always, we will keep you informed!
