SPRINGFIELD, Mo. – One of the largest health insurers in the U.S. has announced it is going to stop selling some of its Missouri plans.
United Healthcare will no longer sell individual plans on the state’s health exchange, starting next year.
United Healthcare covered almost 800,0000 people in 34 states on the exchanges this year, but expects to lose more than $650 million on that business.
The ACA opened up the healthcare system to millions of people who did not have coverage previously, but insurers are not seeing the boon they anticipated.
The law does not let insurers use pre-existing conditions to set the cost of coverage, but Springfield Insurance Broker Trevor Croley said that makes it more difficult to find out who is enrolling in their plans.
“Before they had the ability to look and predict where some of these expenses may be incurred with these people coming into these exchanges or with an individual policy, so when somebody signs up they [the insurer] get what they get,” Croley said.
For many insurers, the customers buying their plans on the exchanges are often new entrants to the health care system.
They are often older, sicker and have used that coverage more than insurers predicted.
United Healthcare said it lost $475 million on the exchanges nationwide last year, and expects that to go up to $650 million this year.
“They either started the process of filing their new plans with the federal government and realized hey this is not going to work or they were looking at past year end statements and they were saying oh my gosh,” Croley said.
Several insurers compete for exchange customer’s business in Missouri.
With United leaving, Corley hopes Missouri does not end up like Kansas.
“Coventry pulled out of the state exchanges there and there’s only really one health carrier in the state of Kansas,” Croley said. “It’s Blue-Cross, Blue-Shield. So what happens in a situation like that well they can probably charge what they want to charge.”
The ACA was supposed to increase access to healthcare and make it more affordable.
Croley said it is harder to find evidence the law has done the latter.
“The equation is the consumer, the insurance company, the medical field and the federal government,” Croley said. “So somebody has to get squeezed in order to make this an affordable scenario.”
United Healthcare was one of six companies selling plans in Missouri’s exchange this year.
The company announced Missouri policy holders will get a letter in the mail at least 180 days before Jan. 1, 2017, letting them know their plan will not be renewed.