How Insurance Exchange Instability Could Affect ACA’s Future

Health Payer Intelligence interviewed Manatt’s Joel Ario and Chiquita Brooks-LaSure, managing directors with Manatt Health, for an article about some of the biggest regulatory issues of the Affordable Care Act and the solutions that could help improve conditions for commercial payers operating through the exchanges.

“On the marketplaces, payers face a problem of not enough enrollment. There is currently an older and sicker pool than the insurers were counting on,” Ario said. “That is [the reason] behind why there have been issues with participation on the exchanges among payers. Having said that, there is currently a solid risk pool that has staying power so no matter what happens, the Affordable Care Act will continue and that risk pool will work primarily because there are a lot of people that get subsidies in that risk pool. It’s not going away.”

“The Marketplaces and exchanges gain the most attention and concern,” Brooks-LaSure explained. “In terms of Medicaid and managed care, we’re seeing across the country increased penetration where more populations are moving into managed care plans. The recent Medicaid/managed care rule has a lot of attention paid to trying to align with the rules of the marketplace and with Medicare. This is a priority to insurers since more of them are participating in multiple programs in the marketplace along with Medicaid and Medicare.”

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