Insurers are struggling to set 2015 prices for exchange plans because some of the most essential aspects that factor into their decisions remain unknown.
The key challenges to setting rates before the spring deadline, insurers say, is that they still don't know the size of provider networks that the federal government will approve or the health status of new policyholders, Reuters reported.
Lacking such information also makes it difficult for insurers to decide which markets to participate in next year. "I can't tell you exactly yet that we've decided about counties and products and all those pieces, but we feel like participating in the marketplaces is very consistent with our mission," Jon Urbanek, senior vice president of commercial markets at Florida Blue, told Reuters.
Some insurers, especially larger companies, might exit some individual markets or avoid entering new ones. Indeed, Cigna CEO David Cordani said the insurer hasn't yet decided whether it will enter any new markets, although "that decision needs to be made in short order," he told the news outlet.
Meanwhile, small insurers may pull out completely from certain markets, particularly if they can't sufficiently rebound to overcome the exchanges' rocky rollout.
"There will be some sort of a shakeout," said Tim Jost, a health law expert and professor at Washington and Lee University in Virginia. The most vulnerable include small health plans and consumer oriented and operated plans that priced their policies too high and only signed up few customers.
For example, Connecticut CO-OP HealthyCT charged up to 29 percent more than its competitors and enrolled only 3 percent of the state's marketplace consumers, FierceHealthPayer previously reported.
To learn more:
- read the Reuters article