Absence of federal fee raises HMSA’s profit

Obamacare hasn’t been repealed and replaced yet under the administration of President Donald Trump, but the suspension of an Affordable Care Act fee for insurers greatly benefited the state’s largest health insurer.

The Hawaii Medical ­Service Association earned $25 million in the first three months of this year, according to first-quarter financial results set for publication today and filed with the state Insurance Division.

The positive return compared with a $30.4 million loss in the same quarter last year.

The biggest factor in the recent gain was the absence of the ACA fee, which Congress decided last year to suspend this year. This fee, which partly goes to the federal government and is used to reduce insurance costs for low-income residents, amounted to $55.7 million for HMSA in last year’s first quarter. Insurers like HMSA are required to record the fee for a full year in the first quarter.

HMSA said it isn’t sure whether the fee will resume in 2018 under the Trump administration, so the ­company is focused on improving operations and maintaining sufficient reserves that can be tapped when expenses exceed revenue.

HMSA was able to increase its reserve by over $100 million to $446.5 million, or $608 per member, at the end of the first quarter, up from $340 million, or $464 per member, at end of the same quarter last year.

“With all of the uncertainty surrounding health care at the federal level, it’s increasingly important for HMSA and our community partners to be able to provide local solutions and financial stability for our members,” Michael Gold, HMSA president and CEO, said in a statement.

Besides the ACA insurer fee, other fees tied to Obamacare fell to $752,562 for HMSA in the first quarter from $3.3 million a year earlier.

HMSA also reduced traditional administrative expenses to $70 million in the recent quarter from $73.6 million a year earlier.

Gold credited HMSA employees with wisely managing member premiums as well as work by the insurer’s health care partners. “As the cost of health care services continues to rise, we’re constantly challenging ourselves to find better ways to work with hospitals and pharmacies, physicians and employer groups, to deliver better value to our members,” he said.

Another boost to HMSA’s bottom line was from returns on money it invests. This investment return totaled $4.6 million in the first quarter, up from $3.2 million a year earlier.

Revenue from health insurance premiums paid by members rose 6 percent in the first quarter to $828 million from $782.6 million a year earlier. The increase was mainly due to the addition of members, which grew to 734,859 from 732,315 in the year-over-year period.

The amount of those ­premiums spent on care rose a bit more, by 7.4 percent, to $730.8 million from $680.5 million, in the same period.