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August 31, 2016 at 11:57 AM
Insurers probably lost a total of about $6 billion on individual major medical insurance plans in 2015, according to Mark Farrah Associates.
Analysts at the Portland, Maine-based firm say, based on a review of statutory financial statements, that issuers probably lost money on individual health coverage in 41 states and the District of Columbia, and that they made money in nine states.
Issuers in Texas, the state with the worst individual health losses, lost about $717 million, the analysts estimate. The analysts did not give premium revenue figures.
Related: Aetna’s Obamacare brushback is part of the game
The analysts found 2015 Supplemental Health Care Exhibit filings for 194 companies. Of those, 133 reported losing money in the individual health market.
The figures include both Affordable Care Act public exchange plans and off-exchange plans.
The figures do not include retroactive adjustments the companies may have to make to reflect the cash received from or paid into the ACA reinsurance, risk adjustment and risk corridors programs.
The analysts also estimate, based on data from statutory filings, public exchange enrollment reports and state regulators, that off-exchange policies are covering 7.5 million of the people with individual health coverage, and that ACA exchange plans are covering 12.7 million of the individual health insureds.
