Health insurers are planning to sell health insurance plans for 2017
Posted On August 7, 2021
Health insurance companies are gearing up for a year that could see the birth of one of the biggest challenges to the Affordable Care Act: The emergence of catastrophic insurance.
The industry has been pushing for years to make catastrophic insurance available to its customers, saying it’s one of their few ways to reduce medical costs for people with pre-existing conditions.
But insurers have faced resistance from some state regulators who say the plan would likely be too expensive.
So now insurers are starting to worry that it might not be possible to meet demand for their products.
Insurers say they’ve had to scramble to find creative ways to make coverage affordable.
The industry has had to adjust to a changing market in which people increasingly want to be covered, and insurers are scrambling to find a way to keep premiums affordable for the millions of people who currently have coverage under the ACA.
“In 2017, insurers have to decide what’s going to be affordable,” said Dr. Matthew L. O’Malley, a senior health economist at Kaiser Family Foundation.
“Is there going to come a time when we can’t offer affordable health insurance?
Or is there going in the future when it becomes unaffordable?
And what will be affordable?
That will be a question insurers are going to have to grapple with.”
Insurers have been exploring a number of ways to offer the catastrophic option, including using the money to pay for additional coverage or providing health benefits, which some have argued could lead to higher costs.
The most popular options, however, are selling insurance that includes no health insurance at all, which would likely leave consumers without the option to purchase coverage elsewhere.
The Affordable Care, or ACA, is a landmark piece of legislation that provides coverage to millions of Americans, but many insurers have argued that it doesn’t go far enough to provide coverage for everyone.
For example, many people can’t get insurance through the ACA because they lack coverage in other states, or are insured in a high-deductible plan, which covers higher costs and more expensive medications.
Many insurers, including some big ones like UnitedHealth Group, have begun exploring ways to provide a catastrophic option.
Under this model, a person would purchase a plan in which their premiums would be based on their health insurance status, rather than on income.
The plan would have to cover everything that the person is covered under, from hospitalizations to mental health treatment, even medical expenses like prescription drugs and prescription drugs out of pocket.
Insurance companies have had to find other ways to sell catastrophic insurance plans, including charging more for it.
For the most part, insurers will not offer catastrophic plans in the individual market, meaning the premiums for individual plans will not be charged.
The premiums for large employers, however have been raised to make up for that, and they can still charge customers for catastrophic insurance in the employer-sponsored market.
Insiders have also struggled to find ways to keep the cost of catastrophic coverage low for people without health insurance.
The ACA mandates that all health insurance be purchased through the government, and many people without coverage don’t have the money for private coverage.
Insurer analysts are starting the year with some hope, however.
For instance, Blue Cross Blue Shield of Florida has announced plans to launch a plan next year that includes a catastrophic coverage option.
Blue Cross Blue is hoping that a catastrophic plan would attract more people to its plans, and also that the market will become more competitive.
Blue Cross is also testing other plans for 2018, including a plan that covers only pre-pandemic illnesses and a plan for the most expensive type of catastrophic plan.
Insuring people with preexisting conditions could also be difficult for insurers to meet in the near future.
Insurers are also trying to find the right mix of people for their catastrophic insurance, so that it’s not too expensive for the people who need it most.
“The challenge for insurers is that the marketplace has become much more competitive, so they have to find better ways to attract healthy customers, and we have to try to do it with a variety of strategies to attract healthier customers,” said John D. Henshaw, chief executive of the Center for Health Policy at George Mason University.
“There’s not a magic bullet that can do everything.”
Insurance regulators are also worried about the possibility that people who have been denied coverage due to pre-existing conditions will not receive coverage in the catastrophic plan, and may instead pay out-of-pocket costs.
Insured people who are denied coverage from insurers could face higher premiums and be denied benefits for months at a time.
Insider experts are also weighing the pros and cons of making catastrophic coverage available to people who don’t need it, such as older people.
Many people with health problems who have not had coverage in many years have become less likely to need it because of the ACA’s protections against pre-discharge coverage.
That means premiums for catastrophic coverage will likely rise, because the government will likely require insurers to cover more patients who have preex