Health insurers are exiting the Marketplace again. Should consumers be worried?
Why are carriers pulling out of the Marketplace?
Industry groups and insurers have described the current environment as a “perfect storm” for the individual market.
We got a letter from ours - Caresource - they are pulling out. That’s a problem for us. They were the only one with all our doctors. Hopefully we can retain a doctor or two when we have to switch providers for 2027…assuming there is a provider.
Healthcare just gets worse and worse in terms of accessibility and affordability.
You are not alone, by any means.
If you like your doctor, you can keep your doctor.
DB2
And any day now Trump will have a perfect replacement. Remember that large binder they showed 60 Minutes after Trump stormed out first term? It was all blank pages.
I’m on an excellent plan from Nvidia. And yet next year my ENT is going out-of-network. Nice jab DrBob2, but you have NEVER been able to keep your doctor under our system pre-ACA either. This has happened to me several times over the decades.
Health care is the only thing keeping me from retiring today. Hillary was right way back in '92.
The issue isn’t really whether the Marketplace exists. The issue is that insurance networks change. People with employer-sponsored insurance, Medicare Advantage plans, and Marketplace plans all sometimes lose access to particular doctors when insurers renegotiate contracts or leave a market. It’s frustrating, but it’s not unique to the ACA Marketplace.
Pete
There’s nothing more disingenuous than sabotaging the Marketplace, then making the claim that it doesn’t work.
"Several major changes are contributing to that uncertainty, including:
All of these factors are causing enrollment declines and a less healthy risk pool in the individual market."
The current for-profit healthcare model is failing. Patients don’t like it, doctors don’t like it, and lots of money is wasted on corporate profits to return share holder value.
Rising health care cost is a major problem. Medicare costs are rising faster than inflation. Social Security payments are reduced as a result.
This is not sustainable. What can be done about it?
For one the SS cap is too low. For two, it seems every other first-world country has found a way to solve this problem. Except us.
True. When your company switches plans you may or may not be able to access the same doctors.
At the same time, the statement by the POTUS was, shall we say, weak in the ‘truth in advertising’ category.
DB2
We’re so dumb.
and then some characters
Don’t discount the power of corruption when it comes to policy makers bending the knee to healthcare profiteers.
Private enterprise can afford it. Governments cannot.
Private enterprise pays for it out of profits and is tax deductible.
Governments pay for it .out of taxes that many people cannot afford.
The Captain
Sure. But most insurers that leave the marketplace do so because they can’t live with the terms of the marketplace. That happened to us two years ago. We liked them, but they left, so we had to find someone else.
Yes, we are “so dumb”. But, as albaby has pointed out numerous times, we chose this path of healthcare sometime after WWII, and it will be almost impossible to change that path now. Many nations rebuilding after WWII chose public health (UHC). We didn’t really have to rebuild, and ended up choosing insurance. Now our entire system has so much inertia (and self-interest of insurance companies) that it will likely never change.
It’s the self-interest of our policy makers that is holding up change.
The Administration has a solution for that.
My favorite is the non-network health plan where the consumer has perform a Texas Two-Step of asking the insurer what they’ll pay for a medical service, then call around town looking for a doctor that will accept the insurer’s pricing. The conservative Paragon Health Institute assures that consumers will find this empowering and not a pain in the rear end. Health economist warn to brace for the return of “Surprise Billing”, also known as unlimited price gouging.
Free link to Washington Post article.
https://wapo.st/4vcGxP9
Glad I’m on traditional Medicare and don’t have a for-profit health insurance CEO between me and my doctor.
intercst
KFF piece:
Long-Awaited Rule Aims To Boost ACA Choices While Embracing Higher Deductibles - KFF Health News
I’m alright with higher deductibles. We already go Bronze with max deductible. What we do need are the insurance company negotiated rates.