Strategies toStabilize ACA Marketplaces: Lessons from Medicare // Robert Wood Johnson Foundation

Strategies to Stabilize ACA Marketplaces: Lessons from Medicare // Robert Wood Johnson Foundation

The Affordable Care Act’s (ACA) health insurance reforms have led to a dramatic decline in the number of uninsured people and improved the overall quality of coverage for many. At the same time, the health insurance marketplaces created by the law are still in flux. Drafters of the ACA envisioned that the early years of the insurance reforms and marketplaces would be a time of instability and crafted provisions designed to assuage insurers’ concerns about the health risks of the marketplace population and the limits on their ability to control costs by denying coverage to people with pre-existing conditions.

However, while some insurers are doing well and expanding their presence on the ACA marketplaces, many of the private insurance companies upon which the success of the marketplaces depends have experienced losses. Some are reducing the scope of their marketplace participation, raising premium rates, or both, raising concerns among some about the long-term stability of the marketplaces.