Insurers are due to submit preliminary rates to state regulators in the next six weeks. They are operating under a mountain of fundamental uncertainty. I expect tremendous variance in initial rate requests as some insurers will guess optimistically relative to other insurers. As more information comes in over the summer, the variation in rates will decrease. I expect more counties to have only a single ACA insurer in 2021 than in 2020 as one rational response insurers have to fundamental uncertainty is to exit marginal markets.
The LA Times has a really good article on another set of uncertainty that insurers can barely guess at beyond acknowledging that this is something to lose sleep over:
for the sickest patients, infection with the new coronavirus is proving to be a full-body assault, causing damage well beyond the lungs. And even after patients who become severely ill have recovered and cleared the virus, physicians have begun seeing evidence of the infection’s lingering effects.
In a study posted this week, scientists in China examined the blood test results of 34 COVID-19 patients over the course of their hospitalization. In those who survived mild and severe disease alike, the researchers found that many of the biological measures had “failed to return to normal.”…
doctors are worried that in its wake, some organs whose function has been knocked off kilter will not recover quickly, or completely. That could leave patients more vulnerable for months or years to come….
So how much care will someone who survived a severe COVID-19 infection need in 2021?
No one knows.
There is tremendous uncertainty that will tangle up actuarial pricing models for the ACA individual market and every other fully insured market. Insurers won’t have a reasonable estimate of what the consensus future looks like when rates are filed in May. We can expect a journey into the unknown which is not a place an actuary wants to be in.
Uncle Cosmo
Here’s where an actuary becomes a fictionary – if not a fantasiary. All sadisticians ;^D know “data” is a four-letter word – but we also know that without it, we are reduced to cursing the darkness.
satby
I read that and wished they had been more specific about what the findings might indicate, or at least what should be followed up on in subsequent studies.
BruceFromOhio
It is vital the ACA be maintained or improved. The return of “pre-existing condition” clauses to deny care will be hardship on anyone with persistent or recurring health issues, and a sentence to slow death those who manage to survive a COVID-19 infection that resulted in hospitalization.
BruceFromOhio
@Uncle Cosmo: “sadisticians,” whether accidental or deliberate, made me laugh out loud. Cruel irony abounds.
@satby: It’s still early. There will be more, much more, to study.
Uncle Cosmo
@BruceFromOhio: Quite deliberate, I assure you. When I was teaching one evening section of Stat 101 in community college (for pocket change & to keep my hand in) my self-produced syllabus distributed in the first session was customarily labeled “Introduction to Sadistics.” My students always laughed, frequently agreed – & nearly all were pleasantly surprised at course’s end with a decent grade & not the nightmare they feared. It’s really not rocket science (though it ain’t bottle-rocket science either). /tmi
WereBear
@Uncle Cosmo: I developed a healthy respect for it while earning my psychology degree.
Dan B
One of the first cases in the Seattle area was a physician who treated patients from Life Care Center. He was intubated for 16 days he does not remember and on ECMO – oxygenating your blood outside the body. His kidneys, heart, and lungs were failing. He was an offensive linebacker who played in the Rose Bowl in 1996. In other words a big healthy man. What care will he need? And what of people who had no health insurance?