ACA exchange troubles: What policymakers, insurers can do to help


Though critics continue to fret about the future of Affordable Care Act exchanges amid carriers’ mounting financial losses, there are steps that Congress and insurers can take to right the ship, argues an editorial from The Washington Post.

Aetna recently became the latest major insurer to indicate it will rethink its exchange participation, starting with cancelling plans to expand to new markets next year. UnitedHealth and Humana already have said they will pare down their individual market presence in 2017.

Still, these developments do not warrant “high alarm and extreme rhetoric,” the Post writes. Instead, the difficulties require policy solutions.

For one, the federal government must ensure that its method of adjusting costs among marketplace insurers actually works, the editorial says. Some have argued that the design of the risk adjustment program--which distributes funds from plans with healthier members to those with sicker ones--unfairly favors large carriers and thus threatens the viability of smaller insurers. Some health plans have even responded with lawsuits against the federal government.

The Post also suggests that Congress increase the penalty for remaining uninsured, a move it says might help incentivize more individuals to enroll in exchange coverage and thus more evenly spread out costs. The penalty more than doubled this year, though for some consumers it still may be cheaper to pay the fine than to buy a plan.

Finally, insurers should take a page from the success of companies that offer low-cost, narrow-network plans on the exchanges that are modeled after Medicaid plans, the editorial argues. The popularity of these plans sends a strong message to insurers that are struggling that they should consider altering the design of their products, it says.

Not all, however, are so optimistic about the ACA’s prospects. A recent op-ed predicted a bubble is forming within the healthcare sector--in part because sicker-than-expected customers have flocked to the exchanges.

- read the editorial