Health Plan Weekly

By Jinghong Chen

Covered California, the state’s health insurance marketplace, will see a preliminary average rate increase of 1.8% in 2022, California revealed on July 28. As several carriers expanded their coverage areas and a new carrier joined the exchange, there will be 12 issuers providing coverage across the state, with all Californians having two or more choices for the 2022 plan year. Among them, Anthem Blue Cross of California, L.A. Care Health Plan, Molina Healthcare and Sharp Health Plan proposed rate decreases. Kaiser Permanente led the market, with more than 570,000 members as of March 2021.

Health Care Service Corp. (HCSC), the parent company of Blue Cross Blue Shield affiliates in five states, is poised to majorly expand its relatively modest Medicare Advantage footprint.

The insurer said in an Aug. 10 press release that subject to regulatory approval, its MA offerings will grow to serve more than 90 new counties in 2022, “increasing access to new coverage options for more than 1.1 million additional Medicare-eligible individuals,” including those in rural and underserved areas.

Although the health insurance market catering to small businesses has largely remained stable amid the disruption of the COVID-19 pandemic, some health policy experts say there are reasons to be concerned about the market’s future. One recent threat is the surging popularity of so-called level-funded health plans, according to a new report produced by researchers at Georgetown University’s Center on Health Insurance Reforms (CHIR) and the Urban Institute.

“I hope with our report that there’s more awareness that this is an emerging issue,” Megan Houston, a research fellow at CHIR, tells AIS Health, a division of MMIT. “The small-group market is not as discussed as it should be given the issues that they are facing.”

The Department of Justice (DOJ) is considering taking steps to block UnitedHealth Group’s planned acquisition of Change Healthcare Inc., according to press reports. Experts say the DOJ has a strong case — and that if UnitedHealth’s Optum division continues to pursue the transaction in spite of legal action, the suit could drag on for years.

In March, Change Healthcare and UnitedHealth received a request for additional information about their proposed tie-up from the DOJ, signaling that the department would be closely scrutinizing the deal. The American Hospital Association (AHA) sent a letter a few days before the announcement “respectfully request[ing] that [DOJ] conduct a thorough investigation of the proposed transaction because it threatens to reduce competition for the sale of health care information technology services to hospitals and other health care providers.” Legal experts and health care insiders agree with the AHA’s take on the deal.