The chief executive officer of eHealth, Inc. recently reported hearing that some people in the Trump administration would like to try to kill HealthCare.gov, or at least get it out of selling health insurance.
To me, it seems as if that’s a bipartisan shame.
Of course, there are many bipartisan complaints that people can make about HealthCare.gov. It still, apparently, suffers from operational problems.
Under former President Barack Obama, the Centers for Medicare & Medicaid Services was never very good about reporting on HealthCare.gov managers’ success, or failure, at meeting the original program goals, in a clear, concise way. It’s hard for a busy person to figure out how well, or poorly, HealthCare.gov does what it was supposed to do.
And, the obvious, bipartisan truth is that HealthCare.gov has been mean to eHealth and other Web brokers. It’s hard to know whether HealthCare.gov was so mean mainly because of regulatory limitations, technical problems or a belief that HealthCare.gov had to build a monopoly to succeed. But HealthCare.gov managers have never done a good job of sharing the health coverage enrollment sandbox with eHealth’s eHealthInsurance.com health insurance sales system or other web brokers.
Those web brokers developed the idea of selling health coverage online. HealthCare.gov came along, did the same thing, and never gave the existing web brokers the kinds of seamless enrollment tools that would have helped them compete with HealthCare.gov on an even footing. HealthCare.gov managers also failed to make any effort to prod insurers to pay commissions or service fees to any entity other than HealthCare.gov. In that respect, HealthCare.gov is kind of a jerk.
But, on the other hand, HealthCare.gov is a jerk with more than 10 million client relationships generating about $50 billion per year in premium revenue for health insurers, and maybe about $1.5 billion in exchange user fee revenue.
Right now, that business looks awful. But given how tangled much of the ACA system appears to be, it seems reasonable to hope that a moderate increase in regulatory system sanity could make the business profitable.
HealthCare.gov appears to be about 10 times bigger than eHealth, and investors have given eHealth a market capitalization, or total market value, of about $215 million. In other words: If the owners offered eHealth for sale, it might fetch more than $200 million.