If you find health insurance fascinating, this is the time of year when following the industry gets fun. Health insurance carriers are putting together their offerings for the following year. General agencies and brokers are working together to come up with the ideal packages for clients. Employees are preparing for open enrollment with a combination of anticipation and dread.
With so much going on in the world, the health insurance industry is likely to undergo some fundamental changes in 2021. Some of those changes will be easy and seamless. Others will be quite challenging. The challenges are always more fun to watch. So what do you think will be the biggest challenge health insurance companies will face in 2021?
The End of the ACA
The Affordable Care Act (ACA) has been a political hot potato for the last decade. Now, with the passing of Justice Ginsburg and the likely appointment of a conservative replacement, there is a very real chance the ACA will be found unconstitutional by mid-2021.
Insurance companies will have to go back to square one if that happens. They will have to rethink all of their policies. They will have to determine what things stay, what things go, and how much to charge for it all. If the ACA is overturned, insurance companies will have their work cut out for them.
The End of an Antitrust Exemption
Also on the horizon is the possible end of an antitrust exemption that health insurance companies have enjoyed since 1945. With the recent passage of legislation Congress tried to get through a few years ago, all it will take to end the exemption is a passage in the Senate and the president’s signature. Both appear likely.
The bill becoming law would mean health insurance companies are no longer shielded from antitrust laws. They will have to fundamentally change the way they do business in everything from establishing rates to determining coverage options.
A Prolonged Coronavirus Crisis
There was a silver lining to the coronavirus crisis for insurance companies: not having to pay for elective procedures during lockdown saved them a ton of money. As such, profits went through the roof. This creates an interesting conundrum for insurance carriers. Due to the way the ACA is set up, they are going to have to give some of their profits back to consumers.
They have to decide between sending rebate checks or reducing premiums for 2021. That seems pretty straightforward, but a prolonged coronavirus crisis could mean higher expenses in 2021. Insurance carriers cannot afford to be short on cash in the event that happens. They have to find a way to make it all work and still comply with the ACA’s 80/20 rule.
General Economic Realities
If the previous three challenges are not enough to stumble insurance carriers, general economic realities may. According to Dallas-based BenefitMall, employers are having to either scale-back benefits for 2021 or forgo previous plans to improve their packages. There is a good chance that some employers have already dropped health insurance and will not pick it back up.
Fewer employers offering health insurance would obviously mean lower revenues for carriers. Continued uncertainty over coronavirus only makes this challenge worse. How do carriers plan for 2021 when they are not sure if their book of business will remain intact?
Health insurance companies may have made pretty impressive profits this past summer, but it is not all sunshine and roses for them. They are businesses like any other. They are facing their own economic challenges as they look forward to 2021. Which challenge will prove most difficult?
Employers project health plan cost will be higher
Although it is impossible to determine precisely, certain insinuations say employers predict an increase in health care costs by about 5% next year. In other words, growth will increase by the same amount compared to the previous five years.
Information and Service Integration
One of the great challenges is the possibility of taking prescription drugs, although certain international groups are doing everything in their power to reduce the cost of prescriptions. The survey showed that more than 20% of respondents look for a cheaper alternative after receiving a prescription from a doctor. The situation could change and improve only if cooperation was established between the insurer, the manufacturer, and of course, the patient. This is the only way to get realistic whole drugs, prices that will satisfy all three parties. If this does not happen, drug prices will continue to be set by legislators, which will significantly reduce drug fees.
Protecting the Public Health’s Devices
The development of technology can negatively affect public health. Although no case has been reported so far, it is believed that hackers can break into almost any medical device. Therefore, the US government warned of this possibility, as well as that hackers are then capable of delivering lethal doses of drugs. Hackers use medical devices to infiltrate information networks and thus steal data. Therefore, IT experts advise separating external from internal consumer medical products and devices, to limit access.
How can a broker contribute to improving the health insurance situation?
The task of a good health insurance broker is to provide the best insurance policy to all clients, and you can find out more on benefitmall.com. By purchasing health insurance through a broker you can be sure that you will get an individual plan at the best price. It also has many other benefits such as quick access to support if needed, as well as customized referrals, as not all insurance packages have the same benefits. When talking about whether you will get cheaper if you take out insurance through a health insurance broker, you must understand the difference between him and the health insurance agent. While the agent works exclusively for one insurance company, the broker works with several of them so you can be sure that he will offer you the best solution.