Individual Market

Originally published in The Los Angeles Times, this perspective examines the potential implications for the individual market if key parts of the Affordable Care Act were repealed without a replacement plan.

A new Kaiser Family Foundation analysis finds that 52 million adults under 65 – or 27 percent of that population — have pre-existing health conditions that would likely make them uninsurable if they applied for health coverage under medical underwriting practices that existed in most states before insurance regulation changes…

This brief reviews medical underwriting practices by private insurers in the individual health insurance market prior to 2014, and estimates how many American adults could face difficulty obtaining private individual market insurance because of a pre-existing condition if the Affordable Care Act (also known as Obamacare) were repealed or amended and such practices resumed.

State data from the Kaiser Family Foundation estimate that 9.4 million Americans who bought health plans through Affordable Care Act marketplaces will receive a total of about $32.8 billion in premium tax credits for 2016. A repeal of the health law would eliminate these subsidies.

This brief analyzes 2017 Affordable Care Act (ACA) marketplace data on premium and insurer participation, including data made available through Healthcare.gov on October 24, 2017, as well as data collected from states that run their own exchange websites.

On Tuesday, October 25, from 1 p.m. to 2 p.m. ET, the Kaiser Family Foundation will examine key issues affecting this year’s annual Affordable Care Act enrollment period and answer audience questions during a web briefing.

To gauge whether individual market risk pools are healthier in states that have expanded Medicaid and did not allow transitional plans, this data note compares average state risk scores using data from the Centers for Medicare & Medicaid Services Summary Report on Risk Adjustment for the 2015 benefit year. The analysis finds that states that expanded Medicaid and did not allow transitional plans had lower average risk scores, suggesting the risk pools in those state’s markets are healthier than in non-expansion states and in states that allowed transitional plans.

In this Wall Street Journal Think Tank column, Drew Altman discusses the latest challenges faced by the Affordable Care Act (ACA) marketplaces and why they should be kept in perspective: “If Obamacare had bipartisan support, they would be treated much more like mundane implementation issues to be addressed by Congress than glaring headlines about Obamacare failure.”

This analysis provides a preliminary picture of the potential effect insurer exits and entrants may have on competition and consumer choice in the 2017 Affordable Care Act (ACA) marketplaces. Much is still unknown and the majority of states’ 2017 filings are either redacted or unavailable publicly.