The Affordable Care Act (ACA) is marking a decade since it began operations. During this period, coverage has doubled according to a recent report by Oliver Wyman consulting firm. The report further notes that ACA enrollment continues to grow, with expectations that 2024 Marketplace enrollment will hit 19 million people.
The ACA has seen considerable volatility over the last decade with consistent regulatory changes. But going forward, Oliver Wyman expects more stability and identified five key ways that the ACA is anticipated to evolve over the next ten years:
- Marketplace success will be primarily driven by scale. The greatest market share will likely belong to large carriers with the resources to handle changing regulations and risks in entering new markets. Presently, Centene holds the greatest ACA market share with a year on year membership growth of 75%, a success attributed to various factors as detailed here.
- Individual Coverage Health Reimbursement Arrangement (ICHRA) may disrupt industry norms. The popularity of ICHRAs, which allows tax-free reimbursement for employees purchasing their health plans, has grown since 2020. Further information on ICHRAs can be found here.
- Carriers will create networks exclusively designed for the Exchange. About 72% of ACA Exchange plans in 2019 were narrow networks, and demand remains high for cost effective coverage options.
- More states will transition to state-based Exchanges. A proposed rule by the Centers for Medicare and Medicaid Services will require states to operate under the framework of a state-based Marketplace on the federal platform for a year before shifting to their own Exchange.
- The need for a seamless member experience will be essential. Younger generations, who expect digital and transparent services, make up a significant portion of the cost-conscious ACA Exchange members.
This analysis underscores the ever-evolving nature of the ACA landscape, calling for a keen eye on the moving pieces and careful navigation to maximize opportunities. Further reading can be found on the original article here.