Last week the nation’s largest health insurer, UnitedHealth Group, announced that they will be exiting most of the states that they currently offer plans through the Affordable Care Act insurance exchanges in 2017. UnitedHealth Group was slow to enter the insurance exchanges in 2014 and according to CEO Stephen J. Hemsley, the small market size and greater expense of patients insured through the marketplaces led to the decision to withdraw from most of the exchanges all together in 2017. The company expects to lose $650 million in 2016 through the exchanges.

Percent of US counties with just one or two insurers in 2016, before and after United exit

The most significant effect that is being projected is the decrease in insurer options for consumers in these markets. According to Kaiser Family Foundation, market analysts suggest a minimum of three insurers in a market in order to promote sufficient competition. With United’s withdrawal and the assumption that there will not be new entrants, the number of counties with three or more insurers will decrease from 64% to 48%. The number of counties with two insurers will decrease from 29% to 28%. More notably, however, is that the number of counties with just one insurer will increase from 7% to 24%. This equates to 1.8 million enrollees that would go from having three insurer options to two. The number of enrollees that would go from having two insurer options to just one would be another 1.1 million. Adequate insurer competition is critical in setting benchmark premiums and maintaining the plan premiums designated by the insurers.

United’s withdrawal, leading to decreased insurer options, could give the remaining participating plans more power to raise premiums. There is also nothing to suggest that United will be the only insurer to decide to exit the insurance exchanges. Although we do not know what the effects will be following United’s withdrawal, the projected decrease in competition and likelihood of price increases will only increase the demand for more payment options for patients. As a medical provider, you may not have control over the decisions of the insurers participating in the exchanges, but you do have control over the payment options you provide your patients.

About MyLoans™

By providing patients with fast access to medical loans at a fair and unchanging interest rate, the MyLoans™ software by Epic River enables financial institutions to ease the financial stress of health care through collaboration with medical providers. Not only can medical providers offer patient financing for medical care needs, but doctors and hospitals alike can finally get immediate funding of their patient’s outstanding balances. Additionally, financial institutions gain new customers and interest income with little administrative overhead in exchange for servicing the loan. For more information, visit www.myloans.co.

About Epic River, LLC
Since its inception in 2005, Epic River has been providing high quality software services aimed at solving process-intensive problems. With a focus on high quality and rapid delivery, Epic River’s methodology accelerates the process of innovation while keeping a firm grasp on the business case behind the application, enabling our partners to grow their market leadership. The company’s unique approach to the agile methodology and user experience ensures both parties work closely together every step of the way. Whether you’re looking to expand into new technologies or markets, need a custom internal tool, assistance with architecture, or simply need someone you can trust to make technology decisions, Epic River is at your service. For more information, visit www.epicriver.com.