The Clinton Herald, Clinton, Iowa

National News

April 3, 2014

Nonprofit insurers struggle in new marketplaces

(Continued)

Beilenson said he’s confident the added business will enable his co-op to enroll greater numbers of people with less effort, and he hopes Evergreen will be able to return to its priority of offering high-quality care to working and middle class families, once Maryland’s enrollment system is improved.

“I would hope that it works vastly better next year than this year,” he said.

But if enrollments do remain low, there are some protections over the next several years. The law included temporary programs that basically provide money to participating insurers to help them financially balance the risk and offset rising insurance premiums, said Dylan H. Roby, director of the Health Economics and Evaluation Research Program at the UCLA Center for Health Policy Research.

The competition to date might not be what Obama envisioned but it’s also not fatal to the exchanges because the law is so new. But all nonprofits selling plans on the exchanges, including the co-ops, will need market share eventually, acknowledged Roby.

Sharp Health Plan, owned by a San Diego regional health care provider, has received about 10,000 applications, or a 10 percent market share. CEO Melissa Hayden-Cook said the financial viability of competing on the Covered California health exchange won’t be clear until months after the first year people have policies.

“It takes time to know how the business model is going to perform,” she said. “But with federal protection to help offset some of those risks, we’re cautiously optimistic.”

Most people buying plans through the exchanges are getting subsidies that lower their premium costs, but deductibles remain costly, so the enrollment numbers will likely grow as people become more aware of the law’s requirement to have coverage or risk larger and larger financial penalties.

“You’ll probably see more people biting the bullet and signing up,” Roby said.

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