Individual health insurance exchanges: What we know, what we don’t know, and looking ahead to 2015

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By Catherine M. Murphy-Barron, Hans K. Leida, Victoria Boyarsky | 16 December 2013

The passage of the Patient Protection and Affordable Care Act (ACA) was a major moment for the health insurance industry. It aimed to create mechanisms for purchasing insurance, add vast populations to the ranks of the insured, and institute complex new regulatory layers. Insurers in the individual market faced a heady mix of opportunity and risk as they sallied forth toward participation in state and federal health exchanges.

With the ACA in motion and exchanges open for business, many insurers are eager for the day when they can base their rates on hard data rather than abstractions. It is possible to gain insights from existing data such as insurer participation, participant enrollment levels, and limited claims data. At the same time, it is important to recognize that even 2015 (or 2016, given the recent announcements delaying portions of the law) will still be early days for the exchanges, and it will be several years before insurers have the claim data they are accustomed to.