Why Are Health Insurance Companies Pulling Out of the ACA Exchanges?

Insurance companies are reluctant to stay in the ACA exchanges because they fear a few situations that may come to pass for their companies. This article explains why insurance carriers are nervous about the exchanges, and there is a look at what each company stands to lose if they stay in the exchanges for too long. Everyone who is buying through the exchanges must ensure they have an understanding of what each insurance company is thinking.

Coverage Gaps

Employees cannot go from one company to another while keeping their insurance, and insurance companies are often left in a bad position as they will be blamed for any gaps that may exist. The exchange is the culprit, and the insurance companies must pick up the slack when someone is trying to change jobs. The companies will pick up too many policies in the interim, and changing from one to another may be quite complicated. The amount of work the insurance company must do is massive, and it is not in their best interests to create multiple policies for the same person given a small gap in coverage.

The Publicity

Insurance companies are pulling from ACA exchanges as they know the publicity for coverage gaps may be problematic. They do not wish to be blamed for things that are out of their control, and they will spend time getting their reputation back based on their participation in the exchanges. They must ensure they are not in the news for things they did not do, and they may be in the midst of a firestorm of public scorn based on a single story about someone who may have purchased their insurance through each exchange.

The Policies

There are quite a few restrictions on the policies that may be offered through the exchanges, and it is quite difficult for companies to build new policies for the exchanges that are completely different from their traditional line of products. Insurance companies will spend more money on new policies, and it will be too difficult to service each new policy. They will not have time to help each customer, and the policies may have gaps in them due to a quick release.

The Extra Manpower Needed

The manpower needed to service each policy may be quite massive, and someone who is in need of help with their policy must speak to a policy expert who was hired to help with the exchanges and nothing else. The company may need to hire more staff than it can afford, and they will begin to lose money on each policy. The ACA exchanges may see like a lovely place to make money, but they may become a drain on the company’s resources.

The companies that are interested in joining the exchanges through ACA may not wish to enter into an agreement that causes them so many problems. They know there are quite a lot of things that could go wrong, and they wish to avoid those problems if they can. Each issue that noted by an insurance company causes them problems that are simply too difficult to manage, and they will lose money at the same time. They are waiting for a system that will help them to save money and time.

Related resource: 50 Most Affordable Healthcare MBA Degree Programs