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5 PPACA exchange watcher views: Where are we now?

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UnitedHealth Group, Inc. says it’s pulling out of dozens of Patient Protection and Affordable Care Act (PPACA) public health insurance exchange markets.

Centene seems to still like the exchange system.

Anthem seems to be hoping for better days.

Aetna seems noncommittal.

What are health insurance market watchers thinking?

For a look at the views of a sampling of agents, brokers and other professional advisors from around the country, read on.

See also: Centene: We like the PPACA exchange system

Covered bridge in Iowa

1. Ryan White: Davenport, Iowa

Ryan White, an employee benefits consultant with Acumen Advisors, is in a state with a PPACA exchange that seems likely to lose UnitedHealth but gain coverage from Wellmark, a Blue Cross and Blue Shield carrier.

White said he was unfazed by the UnitedHealth move. He views PPACA rules as an automatic impediment to insurers turning a profit.

“The long-term concern would be, can anybody make (the exchange market) work and keep it affordable,” White said.

White added that he and his colleagues are hopeful that the new exchange options from Wellmark will meet the needs of most consumers.

See also: Guaranty funds start paying CoOportunity claims

Farm - for Illinois health insurance market

2. Joe Hickey: Mokena, Illinois

Joe Hickey, an agent at Southpoint Insurance, remains concerned about his ability to provide consumers with a sufficient selection of health insurance plans.

“The first thing that comes to mind is the lack of carriers that are making products available for the individual marketplace,” said Hickey, a 30-year health insurance veteran. “There is a very limited selection of providers for individual health insurance.”

Health insurance agents and brokers in rural Illinois are especially likely to miss being able to offer UnitedHealth products, he said.

“For a carrier to completely pull out of the market like that, it’s a concern,” he said. “It limits our opportunities to find good, valuable health insurance.”

Even if new carriers enter the exchange system in the Illinois, Hickey said, he is afraid health insurance marketplace volatility will get worse before it gets better. He said the fallout from PPACA implementation is damaging the ability of health insurance agents to attract fresh talent to their profession, especially given that a significant portion of carrier sales commissions has dried up.

“I don’t see a lot of new agents coming in to this business,” Hickey said. “The opportunities are questionable, and the future is uncertain.”

See also: PPACA World pain: Highmark, Illinois Blue, eHealth

Colorado health insurance market

3. Andrea Levine: Denver, Colorado

Colorado benefits provider Andrea Levine said she is certified to sell health insurance through her state’s PPACA exchange but has decided to focus on selling group health coverage.

“There’s just fewer carriers for people who really need coverage,” Levine said. “There are less and less options in the exchange, so it’s just going to be harder for people to find coverage, and it’s going to be more expensive.”

See also: Colorado exchange bones up on broker strategy

Oakland bridge - for California health insurance market

4. Michael Lujan: San Francisco Bay area

Even in California, where agents and brokers in markets like San Francisco and Los Angeles have little need to worry about short health insurance product menus, producers see the exchange system going through a challenging adjustment period.

“Early on, most of the carriers expressed concerns about how the risk pools would work,” said Michael Lujan, president of California Association of Health Underwriters (CAHU). “The reality of it has panned out to be closer to what they feared than what they were told.”

Lujan said he views UnitedHealth’s decision to cut back on exchange sales as part of an “awkward stage,” as PPACA continues to settle in. But he added that, in the short-term, brokers and agents in California’s smaller communities may be frustrated by the lack of coverage options, or by constricted provider networks. “If you’re a consumer in that market, that’s pretty tough,” he said.

See also: Limelight strategist: The exchange force is real

Milwaukee health insurance market

5. Morgan Tilleman: Milwaukee

Morgan Tilleman is an attorney with Foley & Lardner, a law firm that represents both health insurers and health care providers. He said it’s too soon to judge how profitable PPACA exchanges can (or cannot) be. 

“If you look across the industry, folks who are on the exchanges are asking for and getting pretty substantial rate increases,” Tilleman said. “That’s going to be part of the pathway to profitability on the exchanges.”

He praised PPACA coverage providers that are successfully selling products to younger, generally healthy consumers.

“Growing enrollments is critical,” he said. “These companies need to be targeting the healthier folks.”

Tilleman added that it will be some time before the insurance industry can make a definitive call about the viability of the PPACA exchanges. “There’s a lot of business left to be done before we can write the story of whether the exchanges worked or not,” the attorney said.

See also: Election forces Wisconsin governor’s hand on health care


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