Thus far, the 2016 Marketplace open enrollment season has signaled nothing but stormy seas ahead.  In order to receive a federal subsidy to help pay for health insurance, qualifying individuals must purchase health insurance through the federal Marketplace or a state-sponsored exchange.  So, what happens when insurers stop offering coverage through the Marketplace?

UnitedHealth, the U.S.’s largest health insurer, announced on November 19 that if it cannot make a profit in 2016, it will drop out of the Marketplace.  Anthem (Blue Cross Blue Shield) and Aetna (Coventry) are two of the biggest insurers in the Marketplace.  Aetna has said it is losing money in the Marketplace.  Anthem is making less than anticipated. 

Both companies have expressed their willingness to be patient with the expectation that covering people through the Marketplace will eventually become more profitable.  However, many analysts fully expect Anthem and Aetna to lose money in the Marketplace next year and potentially change their tune.

What does this mean for individuals and the Affordable Care Act?  Let’s consider Kansas.  In 2015, three insurers offered plans via the Marketplace in Kansas – Anthem, Aetna and United.  Just two weeks before 2016 open enrollment, Aetna announced that it was dropping out of the Marketplace in Kansas (a direct contradiction to their comments about being patient).  If United exits the Marketplace in 2017, Kansas citizens purchasing insurance through the Marketplace would be left with only one option – Anthem.   

While the fate of the Affordable Care Act seems more uncertain than ever, one thing is certain – it is currently the law of the land.  Employers and individuals must continue to comply with all Affordable Care Act requirements while waiting to see what the future holds.      

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