risk-adjustment program sicker-than-average Related: 5 reasons the ACA risk-adjustment storm might blow over

Noteworthy Preliminary 2017 ACA Risk-Adjustment Subtotals
(in millions)
Anthem	$ 260
Health Care Service Corp.	$ 573
Other Blues	$ 1,425
BLUES	$ 2,258

Centene	$ (621)
Kaiser	$ (554)
Molina	$ (853)
BIG NON-BLUES	$ (2,028)

Source: Appendix C to 2017 Benefit Year Risk Adjustment Summary Report - Table 3: Issuer-Specific Information for Individual and Small Group Markets (CMS)

Doubts

ACA risk-adjustment program basics

Worries about what happens when issuers fail, or simply refuse to pay their risk-adjustment program bills.
Whether the risk scores adequately reflect the relative risk of enrollees.
Whether the issuer-level scoring approach is fair to new and rapidly growing plans, which may have little information about enrollees' health.
Whether the issuer-level scoring formula is fair to plans with low average premiums.

The average monthly premium for all non-grandfathered, non-catastrophic individual major medical coverage increased 20 percent, to $472.
The number of issuers in the ACA risk-adjustment program fell 7.8 percent, to 654.
The number of issuers of non-grandfathered, non-catastrophic individual major medical coverage fell 20 percent, to 373.
The number of issuers of non-grandfathered small-group major medical coverage fell 6.7 percent, to 515.
About 21 percent of enrollees in the 2017 non-grandfathered, non-catastrophic individual major medical risk pool had at least one worrisome health condition included in the risk-scoring process, and 3.2 percent had three or more worrisome health conditions.

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