Amid ACA Uncertainty, Covered California ’s Risk Profile Remains Stable

One of the constant concerns about the Affordable Care Act (ACA) and the status of the exchanges involves the average health status of enrollees in these state Marketplaces. While the ACA has helped reduce the uninsured rate to record lows and increased access to needed care, the law, the Obama administration, and the US Supreme Court granted states flexibility in implementation. States could choose whether to operate a state-based exchange, whether to expand Medicaid eligibility, and whether to immediately transition to ACA-compliant products. The amount of autonomy has allowed some state exchanges to thrive, while other states struggle. Most consumers without premium subsidies faced double-digit premium increases in 2017 as the transitional reinsurance program expired, several states were limited to one insurer in some regions, and in 2018 a handful of counties may be left without even one insurer from which to choose. These shortcomings require attention, to be sure, but do not mean that the “Obamacare” individual insurance market is collapsing. If the individual market were in a death spiral, one would expect the aforementioned premium increases to create significant declines in enrollment. But as analysis of ACA Marketplaces has shown, during the most recent open enrollment period, there was no relationship between premium changes and sign-up changes, in contrast to the claims of many pundits. In fact, on a national basis, there has only been a slight decline in enro...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Insurance and Coverage Population Health ACA Marketplaces California Chronic Illness and Disability Payment System Covered California risk adjustment Source Type: blogs