ACA marketplace stability under the microscope

The announcement last month that UnitedHealth is considering leaving the Affordable Care Act exchanges, combined with the news that more than a dozen consumer operated and oriented plans are closing, has renewed skepticism about the stability of the ACA marketplaces. A new blog post from the Commonwealth Fund, however, puts these concerns into perspective, painting a picture that doesn't seem so grim.

First, there is no evidence at the current time that the individual marketplaces are unstable, write Commonwelath Fund President David Blumenthal, M.D., and Sara R. Collins, the organization's vice president of healthcare coverage and access. Many consumers are protected from premium rate increases, and even though premiums rose in 2016 from 2015, overall, they are rising at a slower rate than they were before the implementation of the ACA.

Second, despite premiums increasing, customers are generally happy with their healthcare prices and services. Additionally, plans that receive high ratings can enroll people all year-round, rather than just during the deadline period. UnitedHealth also covers only about 5 percent of ACA marketplace enrollees, the post notes.

In addition, there are some upcoming developments that will bolster the ACA's stability, according to Blumenthal and Collins. From increasing penalties--from $95 per adult in 2014 to $695 per adult in 2016--to taking steps that will increase enrollment via educational opportunities, incentives will drive participation in the health system.

Looking ahead, the blog post suggests making private insurance markets work more effectively. An increase in premiums is raising questions about whether private health insurance will continue to be worth its increasing price to Americans with low and moderate incomes, regardless of where it is acquired. Still, basic reforms in the health delivery system are needed if private leadership and public policy are to come to an agreement.

To learn more:
- read the Commonwealth Fund blog post

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