THE INITIATIVE FOR HEALTH CARE AFFORDABILITY

Driven by local and regional health care leaders, the Initiative for Health Care Affordability seeks to improve consumer access to competitive and affordable health insurance options through risk adjustment reform.  Member companies are based in Michigan, New York, Pennsylvania, and Wisconsin.

 

PROBLEMS WITH

RISK ADJUSTMENT

The risk adjustment program was established by the ACA to stabilize markets so that insurers would be encouraged to offer plans on the individual market, thereby increasing competition and lowering prices.  While well-intentioned, the program has had the opposite effect and is a major contributor to high health care premiums.

1

REDUCES COMPETITION

2

DISCOURAGES ADMINISTRATIVE EFFICIENCY

3

PENALIZES INSURING YOUNG AND HEALTHY

4

PREVENTS LOWERING PREMIUMS

5

CONCENTRATES MARKET POWER

 

UNINTENDED CONSEQUENCES

OF RISK ADJUSTMENT

Enrollees in states such as Michigan and Wisconsin face health care premiums on the individual marketplace that have risen by as much as 45 percent since 2017

 
Increasingly burdensome risk adjustment transfers have weakened marketplace competition, leaving enrollees with fewer choices

 
Lack of competition raises prices: enrollees in uncompetitive markets face premiums 60 percent higher than competitive markets
 

For more information on risk adjustment and the program’s effects on rising health care prices for consumers, please email info@healthcareaffordability.org.

CONTACT
 

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