HPA Predictions for 2014

As 2013 comes to a close, we thought it might be fun to make some predictions for the new year. Here goes…

1. A lot of plans go into effect Jan. 1, but it won’t be a smooth rollout. As with any effective date, people will be screaming because they don’t have their ID cards. And others will learn that their enrollment data was never transmitted to the carriers by HHS. It’ll take a while to sort out and the public’s frustration will create more bad publicity for the administration. This will be somewhat reduced by the lower-than-expected enrollment figures, though a surge in December helped pad the numbers a little.

2. Enrollment in the individual market will continue to increase, and we may end up seeing the 7 million that the CBO predicted. One by-product of the shaky Healthcare.gov rollout is that most people are now aware of the law. In August, 44% of Americans thought it had been repealed or weren’t sure, but now it’s on everyone’s radar. No publicity is bad publicity.

3. As more people begin to benefit from the law (by qualifying for expanded Medicaid, receiving government subsidies, or receiving access due to guaranteed issue), the chances of repeal will be less and less likely. The law will continue to evolve and the government will work to fix what’s broken. With no shot at repeal, opponents may soften their stance a little and some of the fixes may actually see bipartisan support.

4. Those who don’t qualify for individual subsidies – either because of their income or because they have job-based coverage available – will seek out lower-priced alternatives like short-term medical plans. While these solutions may not help them avoid a penalty, they’ll provide the protection their families need at a more affordable price than ACA-qualified plans.

5. Employers will start to make decisions about what they’re going to do. Because the mandate was delayed, many large employers put off their analysis. And many small employers who moved to a 12/1 renewal date have been waiting to make a decision. But as employees begin to learn about the government subsidies that their friends are getting, they’ll look into them and discover that they’re not eligible. And when employers realize how it works, many will choose to abandon their employer-sponsored health plans.

6. Other employers will continue to offer coverage, but they’ll search for lower-priced alternatives. In the small employer market, healthier groups may switch to self-funded options. Larger employers will explore skinny plan options that don’t provide minimum value but help them avoid an across-the-board penalty. And consumer-directed options like HSAs will continue to grow.

7. As some of their group business begins to dissolve, brokers who have been dragging their feet will realize that they need a solution – fast. They’ll finally get serious about getting a private exchange, and they’ll still be able to, but they will have missed some of the initial opportunities. And the longer they wait, the more they’ll miss.

To wrap up this topic, on Thursday we’ll tell you what your top 3 health insurance resolutions should be for 2014. Happy New Year everyone.

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