Marcus Robinson is the senior vice president of individual and family plans at UnitedHealthcare. He sat down with Becker's to discuss the company's major expansion of Affordable Care Act plans in 2023 and how the rollout plays into the payer's larger goal of serving members and addressing the nation's uninsured rate.
In 2023, UnitedHealthcare is offering individual and family plans on the ACA marketplace in 22 states, bringing the company's reach to just under 7 million eligible lives.
Question: In 2018, UnitedHealthcare was only offering ACA plans in two states, but now it's 22. What changed?
Marcus Robinson: The market has stabilized over those years, which is one reason why we've decided to get back into the exchanges. But really, it fulfills our desire to serve more Americans because it's a wonderful cross section of the U.S. population. One of our goals is to help people improve their health outcomes and to improve the overall delivery system. We also have the belief that everyone deserves good quality coverage and access to healthcare. Being back in this line of business really hits on both of those goals.
From a strategic standpoint, it's a great intersection of all the other lines of business at UnitedHealthcare as well: Medicaid, Medicare and commercial. It rounds out our entire portfolio and also serves the mission.
Q: Key features of your ACA plans are $0 unlimited primary care and $0 unlimited virtual urgent care. Why should these be standard features among all ACA plans?
MR: When we're looking for good coverage and access to care, we want to remove barriers. When you look at components of the plan design that people utilize the most often and where a lot of healthcare needs can be met, it's primary care and maintenance medication around generics and Tier 1. It's a win for everyone in the system when people can receive and get care at their doctor's office and also stay under maintenance medication.
We're focusing on components of the plan that people utilize the most, but also moving the needle on health outcomes as well. Through our partner, Walgreens, most of our plans feature Tier 1 and generic medications at $3.
Q: Your colleagues at UnitedHealth Group expect the federal public health emergency to end in January. How are you ensuring continuity of coverage for those needing to switch from Medicaid to ACA plans?
MR: This is big, and it's about advocacy and keeping people covered. There's a lot of projections out there that this could increase the uninsured population when the PHE ends and redetermination begins.
Internally, and also through partnerships with the states and regulators, we want communication out there to our existing Medicaid members and to those who could get redetermined off. UnitedHealthcare individual family plans are a component of that. We want to do a good job of a soft landing or catching of those Medicaid members that could be redetermined off. We're in the spirit of making sure that people stay covered, even outside of UnitedHealthcare's plans.
Q: How can payers best assist states as they face this major redetermination challenge?
MR: Advocacy and education. We're letting the states and everyone involved know that we want to help in the process, whether it's folks coming back on employer plan designs, aging into Medicare, or the individual family plan — it's making sure that people remain covered. It's communication, outreach and informing people of their options if they're being redetermined off of Medicaid.
Q: What conversation should payers be having now regarding an eventual expiration of federal premium subsidies?
MR: What we're always focused on is the member because that's the most important person in the entire ecosystem. Whether subsidies are extended again beyond 2025, it doesn't change our focus on the members and the care they receive. We're still partnering with providers, building out QHPs and plans that are sustainable, and improving care and outcomes for our membership.
UnitedHealthcare has a commitment in this space for the long term. We want to serve members and address the uninsured population. Irrespective of what happens with the subsidies, we're focused on building plan designs that serve members, are affordable, and open access to care.