Obamacare’s supporters cheered a report by the U.S. Department of Health & Human Services, which claimed, based on preliminary evidence, that more insurers will participate in Obamacare exchanges next year:
- In the 44 states for which we have data, 77 issuers will be newly offering coverage in 2015.
- The Federal Marketplace states alone will have 57 more issuers in 2015; a 30 percent net increase over this year.
- The eight State-based Marketplaces where data is already available will have a total of six more issuers in 2015, a ten percent net increase over this year.
- Four of the 36 states in the Federal Marketplace will have at least double the number of issuers they had in 2014.
- In total, 36 states of the 44 will have at least one new issuer next year. And some of the nation’s largest insurance companies will be offering coverage in more than a dozen new states, joining the hundreds of insurance companies already participating in the Marketplace.
This is evidence, according to the media, that Obamacare is here to stay. There is no doubt that insurers are heavily invested in the success of Obamacare. They certainly want the subsidies that flow as tax credits via the exchanges. Nevertheless, I don’t think
that means that Obamacare is a done deal, for at least three reasons:
- Insurers’ losses in exchanges are limited for three years, but the industry loses protection after that. Even the 2015 bailout is not assured.
- Obamacare exchanges are a very small — and shrinking — part of the entire market. Entering the exchanges is not a “bet the company” business decision for insurers.
- Private exchanges are growing rapidly. This demands insurers transform into retail businesses. The business skills to succeed in private exchanges are largely similar to those required to succeed in Obamacare exchanges. So, if an insurers is committed to succeeding in private exchanges (as it must), it is not a big
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strategic or operational lift to engage Obamacare exchanges for the next three years. Indeed, because of the subsidies, engaging with Obamacare exchanges is a low-risk way for an insurer to test and refine the needed skills for private exchanges.