Posted by Curt on 6 December, 2016 at 8:51 pm. 4 comments already!


Doug Badger:

Andy Slavitt will step down as the government official overseeing Obamacare on January 20. He should be charged with leaving the scene of an accident.

Obamacare’s individual markets are a twisted wreckage. Insurers are fleeing them, consumers are shunning them, and Democrats are looking for someone to blame.

They’ve found their culprit in Donald J. Trump.

To hear Obamacare enthusiasts tell it, the exchanges were and are vibrant marketplaces where young and old, healthy and infirm, rich and poor find affordable coverage that meets their needs. Then voters went off their meds and elected Mr. Trump. His pledge to repeal and replace the law threatens to kill these thriving enterprises in their prime.

Even ACA critic Robert Laszewski appears to be peddling that line. Speaking on behalf of his insurance-industry clients in a Vox interview last week, Laszewski said that if Congress and the new administration were to pursue plans to repeal and replace the law, “the Trump administration will have put it in a death spiral.”

Laszewski is wrong. Obamacare already is in a death spiral that is fast approaching its terminal point.

That is because, despite billions in individual and corporate subsidies, insurers are bleeding money. CMS quantified insurers’ 2015 losses in its recent report on “risk corridors.” The risk-corridor program transfers “excess gains” made by some insurers that market Obamacare policies to their competitors who suffer “excess losses.” CMS data showed that insurers’ losses in the individual market eclipsed gains by $5.2 billion in 2015, more than twice the 2014 deficit of $2.2 billion. Losers outnumbered winners by more than five to one. In California’s individual market, touted as an Obamacare success story, excess losses outpaced excess gains by a ratio of 282 to 1.

And 2015 will be remembered as Obamacare’s good old days. Since then, four of the country’s five largest insurers — Aetna, Humana, Cigna and UnitedHealthcare — have all but abandoned the exchanges. The fifth, Anthem, saw its stock price spike upwards last month minutes after its CEO told investors that his company might pull out in 2018.

Blue Cross plans in several states have bolted the market, and most of those that remain have substantially increased their premiums. Blue Cross of Texas, after reporting nearly $884 million in excess losses in 2014 and 2015 and threatening to leave the exchange in 2017, agreed to stay only after it coaxed regulators into approving a rate increase of 44 to 48 percent.

The insurer exodus has left more than one in five Americans with an exchange in which only one company participates. The consequences of dumping all the bad risks onto a single insurer are entirely predictable — that insurer will drop out of the market, leaving no insurers in the exchange.

The program’s death spiral is irreversible. The presumption, which seemed sensible enough, was that subsidies would prevent the program’s collapse. Obamacare exchanges would be the walking dead, sustained by an intravenous drip of government cash. But in order for subsidies to work, there has to be a product to subsidize. Without insurers, there is no insurance market.

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