Health plans are particularly upset that the administration paid out claims in a program designed to stabilize the marketplace at less than 13 percent of what insurers requested. The payouts were low because more insurers lost money than made money, though the U.S. has promised to make up the payments in future years. UnitedHealth, which today cut its 2015 profit forecast, didn’t incorporate payments from the program into its 2015 and 2016 forecast.
‘Serious Challenges’
“We’ve been very clear with the administration about the serious challenges facing consumers and health plans in this exchange market,” AHIP CEO Marilyn Tavenner said in an e-mailed statement. “When health plans cannot rely on the government to meet its obligations, individuals and families are harmed as a result. The Administration must act to ensure this program works as intended and consumers are protected.”
Another challenge for insurers has been slowing enrollment growth. HHS has said it expects about 10 million people will be enrolled at the end of 2016, compared with 9.1 million at the end of this year.
Other insurers have said they’re doing fine.
Centene Corp. on Thursday reiterated its 2015 profit forecast and sad its health insurance marketplace business “continues to perform in line with expectations.” And Kaiser Permanente, which has about 450,000 individual exchange customers across eight states and Washington, D.C., said it’s “strongly committed” to the marketplaces.