Columbus, Ohio – In August we witnessed another challenge to the Affordable Care Act with Aetna announcing their departure from (most) of the public exchange. Joining United Healthcare and Humana and now totaling 40 payers who have withdrawn, a third of the country will now only have one option moving forward. The main driver in their decisions – an unbalanced risk pool with too many high-risk patients needing expensive care is causing massive pretax losses across the board.
Providing affordable, high-quality health care options to consumers is not possible without a balanced risk pool. Fifty-five percent of our individual on-exchange membership is new in 2016, and in the second quarter we saw individuals in need of high-cost care represent an even larger share of our on-exchange population. This population dynamic, coupled with the current inadequate risk adjustment mechanism, results in substantial upward pressure on premiums and creates significant sustainability concerns. – Aetna’s Press Release, August 15th 2016
Why This Matters:
Payers need to have the young and healthy to balance out the population that carries more risk to make sure business runs smoothly. The millennial mindset, as we have learned through our research, shows a majority (62%) see a healthcare professional reactively. With this in mind, the young and healthy (perhaps Millennials) would rather pay as they go versus insure themselves just in case. Are millennials the key to the Affordable Care Act’s Success?
When we market to this generation it is critical to make sure the transfer of value is prominent. Millennials take full responsibility of their health – 71% believe they’re already doing everything they can to maintain a healthy lifestyle. It will be interesting to see how the ACA reacts and campaigns for new enrollees during open enrollment in just a few months.