Obamacare insurers are getting hit by a triple whammy from "special" customers — whose health costs are helping destabilize the program, setting the stage for higher premiums next year, a new report finds.
The analysis from health consultancy Avalere found that people who enroll in Obamacare plans during so-called special enrollment periods have continued to have higher health-care costs than people who sign up during the open-enrollment season.
It also found that such people are costing insurers extra money because a measurement used to calculate their predicted health benefit usage is low-balling what they actually end up using.
The disparity between the predictions and the reality means that insurers are getting less money than they should from an Obamacare program meant to lower financial risk for insurers covering higher-cost customers.
And Avalere's report said that special enrollment Obamacare customers on average spend just 3.6 months enrolled in a plan — less than half of the 7.8-months average for open-enrollment customers.
That shorter time span means that insurers are getting less in total premiums each year from their special enrollment customers than from their open-enrollment customers.