Private Payers News

Kaiser Permanente Will Stay in ACA Health Insurance Exchange

Kaiser Permanente has confirmed their commitment to participate in the ACA healthcare insurance exchange during 2018.

Kaiser will stay in the 2018 ACA markets

Source: Thinkstock

By Jesse Migneault

- Kaiser Permanente will continue to offer coverage options through the ACA health insurance exchanges during 2018, the payer and provider announced this week.

“Kaiser Permanente will continue to offer coverage -- including access to our complete network of world-class providers and services – through health exchanges in every region where we operate,” the organization confirmed to HealthPayerIntelligence.com.

The comment comes several days after CEO Bernard Tyson announced his commitment to the ACA at the WSJ Future of Healthcare Symposium.

“We have been, and will remain, very committed to the individual coverage market,” a spokesman added.

At the event, Tyson pointed to the decrease in the nation’s rate of uninsured and a rise in healthcare delivery innovations as examples of the positive effect the ACA is having on the American healthcare system.

“We have always said everyone should have access to the front door of the American healthcare system,” said Tyson. “You can have access to the door but can’t go through that door if it is still unaffordable.”

“There are people who never had coverage which are now part of the Kaiser Permanente system.”

Tyson also refuted earlier comments by Aetna CEO Mark Bertollini that the ACA exchanges were in a “death-spiral.”

“I would not use that term (death spiral) because we now have 20-plus million people getting access to care through the front door,” said Tyson.  “We still have 30 million more with no coverage.  We still have work to do”

Across the nation, insurers are still submitting quotes and deciding whether to be part of the 2018 individual exchanges. 

Payers are citing many of the same reasons for leaving the exchanges: higher than expected costs, lower than predicted enrollment and uncertainty about the future of federal subsidies.

Some prominent players such as Aetna and UnitedHealthcare, have announced plans to leave the healthcare insurance exchanges entirely for 2018. 

However, some payers are seeing profits stabilize and are making plans to expand their offerings.  

BCBS of Tennessee recently announced it will be expanding into the individual healthcare marketplace in Knoxville, Tennessee.

“I’m pleased to report that, though still very early, our 2017 performance has improved due to a combination of better claims experience and a more sustainable rate structure based on the medical needs of the members we’re serving,” said JD Hickey, President & CEO of BCBS Tennessee in a recent letter to Tennessee Insurance Commissioner Julie Mix McPeak.  

Despite a few bright spots for some companies, Kaiser Permanente CEO Tyson conceded the future of the exchanges will rest on how the nation addresses the fundamental issues of care and cost.

“The main issues facing the healthcare industry today and payers remains, how do we solve the access to affordability?”

“Who’s going to assume the risk for the cost of care for the American people? What do we need to put in place to incent and drive delivery and care reform?”

Kaiser currently operates individual healthcare exchanges in nine states: California, Colorado, the District of Columbia, Georgia, Hawaii, Maryland, Oregon, Virginia and Washington State.