Behind the Scenes

Affordable Care Act Losses Mounting for Some Health Insurance Providers

Wellness has been at the forefront of our minds here at Club Industry this year for a variety of reasons.

Genavix Wellness Network President and CEO Mike Benton is one of those reasons. He attended a Club Industry planning meeting earlier this month in Boulder, Colorado, and talked more in-depth about the trends in wellness and how fitness facilities can profit from it.

He also did a great job last month when he presented a webinar about the opportunities for health clubs in the Affordable Care Act (ACA). That webinar is now available for free on demand.

In the webinar, Benton noted how hospitals, primary care physicians, provider networks, employers, insurance carriers and insurance brokers are seeking better ways to manage health care and preventive care.

The money at stake for the providers in managing health care is significant.

A Wall Street Journal report last week profiled how many insurance companies are under pressure to improve margins on ACA plans in 2016. Perhaps the most telling comment in the story came from Blue Cross and Blue Shield of Louisiana, which estimated a $77 million loss on individual plans in 2015, up from a $66 million loss in 2014.

The "overall risk of people buying insurance on the exchanges is much higher than planned for," in part because the law has not attracted enough healthy employees, Blue Cross and Blue Shield of Louisiana told the Wall Street Journal. The losses are unsustainable in the long term, the company said.

One of the key takeaways from the piece is that financial losses on individual plans have pushed some startup insurers out of business and larger insurers are seeking rate boosts to cover losses. Last November, United Health Care threatened to abandon the health care exchange, and last month said it is expecting losses of more than $500 million on its 2016 ACA plans, according to the Wall Street Journal.

Preventive care, which includes a balanced diet and exercise, is a huge component of a healthy lifestyle, and it can curb costs for insurance providers. Health clubs can be part of the solution for the people these providers serve.

You will be seeing more stories on wellness topics from Club Industry this year. Those stories can be seen in our trends section on our dedicated wellness page.

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