Healthcare Business News
Joseph Swedish, WellPoint

Insurance execs say they're not panicking about exchange enrollment

By Beth Kutscher
Posted: January 15, 2014 - 7:45 am ET

Health insurers are expressing measured optimism for enrollment in the coverage they're selling on the health insurance exchanges after quietly grumbling for weeks that the fumbled rollout was undermining their business plans.

Some health insurance executives expressed some modest bullishness on the exchanges Tuesday at the JP Morgan Healthcare conference in San Francisco, even though a day earlier HHS revealed that the enrollees so far are skewing older than many had hoped.

WellPoint President and CEO Joseph Swedish said he expects exchange enrollment to accelerate as people gain more familiarity with the plans and the potential subsidies available, and as a larger number of employers begin to gradually shift employees to the marketplaces.

Advertisement | View Media Kit


Swedish acknowledged that the technical glitches that plagued the site led to lower-than-anticipated enrollment but said he is encouraged by the “sizable uptick” the insurer saw at the end of December, the first deadline for enrollment. Another surge, he noted, is expected as the second enrollment deadline approaches in March.

In a financial filing last week, Humana offered a different take on exchange enrollment, disclosing that it is expecting a more adverse risk pool than previously expected. But in a question-and-answer session after Humana's conference presentation, President and CEO Bruce Broussard said “there's not a lot of science” behind that projection.

Humana has seen a higher-than-expected number of people opt to stay with their individual plans—the ones that don't meet the coverage requirements of the ACA—after the government yielded to consumer backlash and allowed the coverage to be extended.

The number of members making that choice remains unclear. “We don't have a complete picture of that,” Broussard said, adding that he couldn't say yet whether Humana will pull out of any of the markets where it offers its plans on an exchange. “There are too many uncertainties right now.”

Expectations are decidedly more upbeat at Health Net, which is selling exchange products in California, Arizona and Oregon. “I think we now feel we're all-in, and we're happy we are,” President and CEO Jay Gellert said.

The company's exchange plans have a 15% to 17% market share in California, which has enrolled nearly 500,000 individuals through Covered California and has seen one of the most successful rollouts in the country.

“We believe that this population will continue to grow,” Gellert said. “It's working in California—and it's working in the West—and I think it will be an example for the rest of the country.”

Insurance executives at the JP Morgan conference consistently said that business in government health programs will be key to increasing revenue.

WellPoint, which bought Medicaid and Medicare managed-care provider AmeriGroup in 2012, said its government business now accounts for 45% of its revenue base, or $31 billion last year.

Health Net and Humana also said they've seen higher-than-expected enrollment in their Medicare Advantage plans.

Even integrated Geisinger Health System, which offers its own health plans, is seeing more opportunity in Medicare managed care than in capitated, payment-for-value contracts. Medicare will expand “much more rapidly than any other payer,” President and CEO Glenn Steele said during a presentation Monday.

Geisinger participates in the Keystone Accountable Care Organization, “but our big bet is not ACOs,” Steele said. “Our big bet is Medicare MCOs.”

Follow Beth Kutscher on Twitter: @MHbkutscher

What do you think?

Share your opinion. Send a letter to the Editor or Post a comment below.

Post a comment

Loading Comments Loading comments...



Switch to the new Modern Healthcare Daily News app

For the best experience of on your iPad, switch to the new Modern Healthcare app — it's optimized for your device but there is no need to download.