Next-generation 2018 health policies may be spawning now

Some of the insurers that will “reduce the size of their footprints” in the individual commercial health market in 2017 could be back with galoshes in 2018.

Proteus Duxbury, a Denver-based health care consultant, gave that assessment Monday in an interview about the current state of the market.

Duxbury, who now works for London-based PA Consulting Group, watched the previous round of plan building up close. He was the chief technology officer at Connect for Health Colorado, Colorado’s state-based Affordable Care Act exchange.

Related: 3 darts for agents in the new ACA 2018 draft rules

He had to help managers of Connect for Health Colorado connect with federal ACA exchange systems, and he watched carriers learn how to build, and hook up, ACA-compliant individual major medical plans in Colorado.

Neither task was easy, given that the Centers for Medicare & Medicaid Services (CMS), the arm of the U.S. Department of Health and Human Services in charge of implementing ACA programs, tends to be a cautious organization, and the ACA required CMS, the state-based exchanges and the insurers get the exchange program up and running only about 18 months after the U.S. Supreme Court had declared core ACA provisions to be constitutional for the provisions to take effect.

This year, now that some of the new, underpriced, ACA-inspired carriers have left the market, “I think there’s a feeling of stabilization,” Duxbury said.

In spite of all of the reports about individual health service area cutbacks, “I think there’s optimism,” he said.

Continue reading…

The established players will be back, as early as 2018, with leaner, cheaper plans that are better tailored to the needs of the modern individual market, Duxbury said.

“It’s too early to tell if they’ll be successful,” he said.

He said it may also be hard for agents and brokers to get in on the ground floor.