- The Washington Times - Sunday, November 22, 2015

The administration, seeking to boost confidence in Obamacare after a top insurer said it might exit the program within two years, is highlighting health plans that say they’re “doing fine” in the emerging marketplace.

It also said it will do what it can to make up an early shortfall in payments baked into the Affordable Care Act to protect plans against heavy losses from 2014 to 2016.

UnitedHealth Group, which serves roughly 550,00 Obamacare customers, stunned the health care industry last week by saying it will scale back its exchange marketing in 2016 then decide if it’s worth participating in 2017. It cited heavy losses among a volatile and costly customer base on the exchanges, where customers can shop for health plans and qualify for government subsidies that make coverage more affordable.

Other insurers said they remained optimistic about the program and had no reason to revise their expectations in the wake of UnitedHealth’s remarks.

Molina Healthcare, which serves nearly 230,000 exchange customers, told the UBS financial services firm “it is not unusual for there to need to be modifications in a developing new market, but that it is too early to question the long term viability of the public exchange markets.”

The Centene Corp. and Aetna reported no changes to their outlooks, although the latter did warn that an increasing number of people were moving in and out the exchanges.


SEE ALSO: UnitedHealth Group, nation’s largest insurer, may drop out of Obamacare, citing losses


“We are pleased to see comments from health insurance companies like Aetna, Anthem, Kaiser Permanente, Molina, and Centene reiterating that they remain committed to their current Marketplace participation,” said Ben Wakana spokesman for the Department of Health and Human Services. “This is further indication that statements from one issuer are not reflective of the marketplace’s overall strength going forward.”

Obamacare’s third open enrollment period began Nov. 1 and lasts until Jan. 31. More than 1 million people have selected plans so far — though two thirds were returning customers — as HHS tries to hit a modest goal of 10 million paying customers for 2016.

“More Americans are getting covered, and we’re confident this positive trend will continue,” Mr. Wakana said.

Meanwhile, the Centers for Medicare and Medicaid Services (CMS) reiterated late Thursday that plans would receive only 12.6 percent of what they thought they would get in 2014 risk corridor payments, which is money the government promised to cover losses in poor-performing plans.

The health law requires the administration to make the full payments, but Congress has mandated that the program be budget neutral, so lawmakers aren’t about to rescue insurers who faced a sicker-than-expected customer base.

In a memo, CMS reminded insurers that it can roll over what it owes for 2014 into the next two years of payments, and that it would seek money from Congress if things do not improve after the 2016 plan year.


SEE ALSO: More than 1M have selected plans on Obamacare website


The agency said it would “explore other sources of funding for risk corridors payments, subject to the availability of appropriations.”

“This includes working with Congress on the necessary funding for outstanding risk corridors payments,” the memo said.

Congressional Republicans and conservative groups will surely oppose attempts to boost the program, however. They’ve blasted it as a “bailout” for insurers.

“The solution is to get government out of the way — not dig the hole even deeper,” said Nathan Nascimento, senior policy adviser at Freedom Partners.

• Tom Howell Jr. can be reached at thowell@washingtontimes.com.

Copyright © 2024 The Washington Times, LLC. Click here for reprint permission.

Please read our comment policy before commenting.

Click to Read More and View Comments

Click to Hide