What insurers leaving Obamacare exchange means for physicians
Recent analysis by the consulting firm McKinsey & Co. reveals that many insurers are losing money in ACA individual markets, with aggregate year over year losses more than doubling, and with post-tax margins between –9% and –12%. Losses like these resulted in UnitedHealth Group leaving the California ACA market after only one year.
That decision, as well as other insurers leaving some markets has sounded some alarm bells, particularly among opponents of the ACA.
Health policy expert Joel White, president of the Council for Affordable Health Coverage, notes this is a phenomenon happening all over the country because not enough people are signing up and insurers are losing money.
According to the Congressional Budget Office only about 10 million of the expected 21 million people have enrolled.
“The risk pools are older and less healthy. And automatic stabilization programs are ending in 2017,” he says. “The combination means rates must go higher, which discourages more enrollment, which makes the market worse.”
What does this mean for physicians?
Adam C. Powell, Ph.D., president of Payer+Provider Syndicate, a management advisory and operational consulting firm focused on the managed care and healthcare delivery industries, notes that physicians who had contracts with insurers that departed the exchanges but not with other insurers may lose patients. Conversely, physicians with contracts with the remaining health plans may gain from the exodus.