Uncertainty and its Effect on the Health Insurance Marketplace

• Insurers have been unsure whether the mandate requiring everyone to have insurance will be repealed.
• Insurers do not know whether the Administration will continue to make payments to compensate them for cost share reduction subsidies given to lower income individuals
• Ultimately insurers will factor in this uncertainty in their premium offerings.
• The ever increasing taxes being buried within the premiums are also creating havoc and in reality are being paid by employers and employees.
• The Federal Risk Adjustment Mandate: This one has really backfired and did not go according to the game plan. It appears it became one of those “OOPS situations. In reality, it is causing one of the major insurers in the NY Market with 18% of the business to exit the health insurance business. The irony is that they were doing very well. The astronomical amount (approx. $112 million) they have to pay because of the Federal Risk Adjustment mandate is not allowing then to be competitive and profitable. This action is causing the most competitive insurance company providing access to quality physicians and hospitals to leave. Northwell CareConnect offered the best price point in the entire marketplace. When comparing apples to apples, the next option is more costly to employees. Once again, small employers and employees get clobbered.​

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