States have received nearly $5 billion in federal grants to establish the online marketplaces [exchanges] used by consumers to enroll in health plans under the ACA [Obamacare]. The federal funding ended at the beginning of the year, and exchanges now are required to cover their operating costs. [our bold]Reports of the life of Reilly are greatly exaggerated? That would seem to be the gist of the story by Lena Sun and Niraj Chokshi;
...for the recently completed open enrollment period, sign-ups for the state marketplaces rose a disappointing 12 percent, to 2.8 million people. That compared with a 61 percent increase for the federal exchange, to 8.8 million people, according to Avalere Health, a consulting firm. States with the smallest enrollment growth are among those facing the greatest financial problems.For those not among the small number of people who buy health insurance on one of the exchanges, this isn't comforting news;
In Colorado, Connecticut, Kentucky, Maryland and the District [of Columbia], fees to support the exchange are imposed on plans sold on and off the marketplaces. In the District, about $25 million of the exchange’s $28 million budget comes from user fees assessed on insurance products not offered on the exchange. [our bold, again]Then, as Megan McArdle reports on Oregon;
Oregon's insurers have filed their 2016 rate requests, and they're large. More than half of the insurers in the market are requesting double-digit increases, with one insurer trying to raise rates by more than 40 percent. Oregon's current moment is just a small sample, of course. But it raises the concern that premiums are about to rise a lot higher and faster than many people were expecting.
This is of concern for two reasons. The first is, of course, the cost to the taxpayer: as premiums rise, so will the subsidies we pay. And the second is what this might portend for the structure of the insurance market. There's already quite a bit of concern that enrollment may be stalling out, with people who get huge subsidies eagerly snapping up the product (who doesn't like things that are practically free?) but higher-income consumers, who get smaller subsidies or none at all, saying "thanks but no thanks" to the relatively pricey high-deductible plans on offer.