New ACA concern: Insurers may drop bronze plans

Given the low profitability of bronze plans in the Affordable Care Act exchanges, some health insurers might stop offering policies on that metal tier, Inside Health Policy reports.

One problem, according to the article, is risk adjustment--as CMS data indicate bronze is the only metal level for which insurers of all sizes in the individual and group markets had to pay into the program. Federal officials are considering some changes to the risk adjustment program, which some say unfairly penalizes smaller insurers.

Already, filings show a CareFirst BlueCross BlueShield subsidiary in Virginia will transform its bronze plans into silver-level plans for 2017, according to Inside Health Policy, and experts tell the publication this could set a troubling precedent for the industry.

If insurers do drop their bronze plans, it would have the effect of further destabilizing the marketplace, according to Sean Mullin, a senior director at Leavitt Partners. That's because such enrollees, which tend to be lower-risk and want the cheapest plans, will likely leave the marketplace altogether, further depleting the exchanges' share of healthier enrollees.

Some insurers that participate on the exchanges--most notably, Blue Cross Blue Shield plans--already are reporting that they have a greater share of high-cost enrollees than they anticipated.

However, it may be too early to speculate on the changes coming with bronze coverage and risk adjustment, the article notes. And health policy expert Tim Jost isn't so sure that dropping bronze plans would be in insurers' best interests.

"It seems to me that if bronze attracts healthier individuals, insurers would stay with them unless the risk adjustment payments more than compensate for the lower costs of coverage," he tells the Inside Health Policy.

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