AHIP gains four new members
America's Health Insurance Plans announced Monday that it scored four new member plans, the first to join the trade group since Obama-era CMS Administrator Marilyn Tavenner left as CEO.
The four plans—CalOptima and Health Plan San Joaquin in California, CareOregon and Priority Health of Michigan—largely represent the increasingly profitable Medicare Advantage and Medicaid managed-care markets, although Priority Health also participates in Michigan's Obamacare exchange.
The plans are the first to join AHIP since Humana severed ties in January—the third high-profile company to do so. UnitedHealth Group and Aetna exited the trade group in 2015 and 2016, respectively.
Although those departures left AHIP with $2.3 million in revenue losses, the association added 11 new members and turned a $1.2 million profit in 2017. Most of the major insurers remain part of the group, including Anthem, Kaiser, many branded Blue Cross and Blue Shield plans and Molina.
AHIP President and CEO Matt Eyles praised the new member plans as "committed to fighting for lower prices for patients and consumers, and to helping people get healthier faster and stay healthier longer."
The trade group's latest expansion accompanies bullish prospects for the industry. The Trump administration continues to signal strong support for Medicare Advantage in particular—as in last week's proposed payment rule that would establish a demonstration to test Medicare Advantage as a value pay model under MACRA.
Insurers spent 2017 navigating the shift in lobbying strategies that followed full GOP control of Washington, as Congress and Trump administration continue reshaping the landscape. The most dramatic changes were seen on the Obamacare exchanges with the effective elimination of the individual mandate penalty and the halting of cost-sharing reduction payments, or CSRs. Insurers blasted the move at the time but ultimately built the cost of CSRs into benchmark silver plans and protected their subsidized markets.
They have also been preparing for expansion of association health plans and short-term plans. Association health plans in particular are expected to affect the small group market.
Still, along with Medicare Advantage and Medicaid managed care, the Obamacare individual market appears poised for a profitable year even as average silver plans are projected to rise an average 15%. No exits have been announced so far and startup health companies and mainstream players like Centene have announced expansions, although last week brought vehement industry criticism of the Trump administration for its suspension earlier this month of risk adjustment transfers.
On Capitol Hill, the industry has recently been advocating for the majority-Republican proposal to expand health savings accounts and to tweak existing laws to let HSA owners use those funds to buy high-deductible plans. A $92 billion legislative package designed to expand HSAs passed out of the House Ways and Means Committee last week and is expected to head for a House floor vote later this month.
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