With insurers' ACA troubles, specter of 'death spiral' rises again

Though warnings of a "death spiral" on the Affordable Care Act exchanges are hardly new, health insurers' continued struggles in the individual market are reigniting questions about that worst-case possibility, according to The Hill.

At a panel this week, Michael Taggart, a consultant with S&P Dow Jones Indices, said a collapse of the market is possible, but noted that he "wouldn't attempt to put a probability on it" because of all the factors that could tip the scales either way. Yet while Kaiser Family Foundation's Larry Levitt tells the publication he thinks "something's got to give"--either insurers drop out or premiums rise--it's more likely it will be the latter, as many plans were priced too low in the first place.

The most recent point of concern is news that UnitedHealth made good on its threat to pull out of the exchanges by exiting the markets in Arkansas and Georgia. The large insurer, however, isn't a major player in either state, and has been a reluctant participant in the exchanges from the start.

Yet there are also signs of trouble for Blues plans, which are dominant in many ACA marketplaces. Blue Cross and Blue Shield of North Carolina, for example, has said it will lose a total of $400 million in the individual market for 2014 through 2015.

"We're not alone, and I think that that also is evidence to suggest that there are systemic and fundamental challenges that we all need to have a civilized conversation about," CEO Brian Wilson tells The Hill.

But Centers for Medicare & Medicaid Services Chief Operating Officer Mandy Cohen tells the publication that the growth she's seen in the marketplaces makes her confident of their long-term sustainability. And she isn't concerned about BCBSNC exiting the exchanges, pointing to its ongoing technology and administrative issues as the driving forces behind its losses.

To learn more:
- read The Hill article

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