The bill would require the insurance commissioner to consider how high-risk members affect premiums; the impact of programs to improve health outcomes and lower costs; and the statutory requirements nonprofit insurers
like CareFirst BlueCross BlueShield have to follow.
Fifteen out of the 23 nonprofit insurers
set up around the country as co-ops under the Affordable Care Act have now gone bankrupt.
Officials in the administration of former President Barack Obama lent CO-OP funding to nonprofit groups that wanted to start CO-OPs, but they put tight restrictions on the CO-OP plans' ability to use the money for marketing, blocked the plans from getting money or management help from existing for-profit or nonprofit insurers
, and prohibited the member owners of the plans from ever selling the plans.
Essentially, entry into health insurance exchanges nationwide is made relatively harder for for-profit insurers, so large nonprofit insurers
stand to benefit.
Many of the nonprofit insurers
are startups and have faced challenges as they tried to attract customers, including: the computer problems that plagued many of the signup websites; plans that weren't priced to compete; and a failure to develop brand recognition, due in part to restrictions on advertising and lobbying that were a condition of the co-ops accepting the federal funding.
Officials also have proposed letting nonprofit insurers
use the same three-year time period to calculate their Section 833(c)(5) MLR and the minimum MLR rebate program MLR.
While most insurers quantify market impact in terms of financial data, the three nonprofit insurers
profiled in the following pages have evolved from a market-driven force that left a segment with coverage issues for one reason or another.
For-profit and nonprofit insurers
are merging and combining forces in ways that increase their leverage over health-care providers and even more so over patients.
Public hospitals and nonprofit insurers
are social assets whose value derives from the time, effort and money contributed by tens of millions of Americans.
In regional and national markets, profitability has remained favorable for both for-profit and nonprofit insurers
These new private nonprofit insurers
will be run by consumers and are designed to offer individuals and small businesses more affordable, consumer-friendly and high-quality health insurance options.
In addition, the conversion of nonprofit insurers
to for-profit status further subjects the industry to Wall Street's unrealistic market-share and profit expectations, neither of which has demonstrated an historical bias for social benefit.