Here are five observations:
1. Premium rates in 2017 will be higher than those in previous years due, in part, to general medical cost trends. Medical spending increases every year and payers take this into consideration.
2. Payers are also watching increasing pharmaceutical spending.
3. Within the ACA, payers face capped profits and are required to cover certain benefits as well as offer coverage to consumers with pre-existing conditions.
4. In 2017, two ACA risk mitigation programs protecting payers from losing money will also end. The reinsurance program and risk corridors program will cease.
5. The purpose of exchanges is to provide affordable health insurance for consumers, allowing consumers to shop for coverage. This leaves payers with little certainty about their consumer base.
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