Health Plan Weekly

Nearly 11.5 million people selected or were automatically reenrolled in health plans for 2023 on HealthCare.gov as of Dec. 15, 2022, an 18% increase over the same time period in 2021, according to CMS. Although the average premium for benchmark silver plans (before accounting for tax credits) increased by 4.1% in 2023 after four years of declines, enrollees receiving subsidies may find their net premiums for low-cost bronze, silver and gold plans are lower than last year, according to a Kaiser Family Foundation analysis.

Here’s how major health insurers’ stock performed in December 2022. UnitedHealth Group had the highest closing stock price among major commercial insurers as of December 30, 2022, at $530.18. Humana Inc. had the highest closing stock price among major Medicare insurers at $512.19.

A group of Blue Cross and Blue Shield affiliates has founded the Synergie Medication Collective, a medication contracting organization focused on improving affordability of clinically administered drugs that are covered under patients’ medical benefit. The goal of the organization is to establish “a more efficient contracting model” for things like multimillion-dollar gene therapies and infusible cancer drugs while “utilizing a transparent business model in collaboration with industry stakeholders.” The independent entity will go to market “in January of 2023,” according to a Jan. 5 press release, and is owned by the Blue Cross Blue Shield Association (BCBSA), Elevance Health, Blues-affiliate-owned Evio Pharmacy Solutions and Prime Therapeutics, and nine regional Blues plans. Pharmaceutical industry veteran Jarrod Henshaw will serve as Synergie’s CEO, and BCBSA President and CEO Kim Keck will be the organization’s initial board chair. 

Three years into the COVID-19 pandemic, enrollment in both commercial health coverage and public health insurance continued its growth. Managed Medicaid membership jumped from 61.4 million in December 2020 to 74.0 million in 2022, while Medicare Advantage (MA) enrollment reached 29.9 million this year, compared with 25.2 million in 2020, according to AIS’s Directory of Health Plans. Commercial health coverage gained 300,000 enrollees over the past year, yet several major health plans reported slight decreases in commercial enrollment, including Centene Corp. and CVS Health Corp.’s Aetna.

While making their financial projections for 2023, health insurers have had to acknowledge that the timing of a major headwind — the resumption of Medicaid eligibility redeterminations — continued to be a question mark. Now, if a newly released draft of Congress’ year-end spending bill is passed as written, that uncertainty will be removed and replaced with a firm date: April 1.  

Industry observers tell AIS Health, a division of MMIT, that it’s helpful for both state governments and managed care organizations to have a definite answer about when millions of people will start losing their Medicaid eligibility — although the event itself remains a net negative for MCOs.