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Health insurance companies used to collect a majority of their premium dollars from people who had coverage through their jobs, but their growing stake in running government health care programs has consumed a larger share of premiums over the past decade.

The big picture: Don't expect this to slow down. More low-income people have gained private Medicaid coverage through the Affordable Care Act, more states are privatizing their Medicaid programs, and more seniors are switching to privately run Medicare Advantage plans.

By the numbers, per data from credit ratings agency A.M. Best:

  • Managed Medicaid, in which states outsource their programs to health insurers, represented only 10% of insurer premiums in 2007. That ballooned to 27% as of last year.
  • Medicare Advantage rose from 17% of premiums in 2007 to almost 25% in 2017. Republicans and Democrats support the program, but it has been tied to waste and over-billing.
  • Commercial premiums have declined from 58% in 2007 to 38% last year.
  • The commercial portion includes the ACA's individual exchanges, where taxpayers cover the vast majority of enrollees' premiums.

The bottom line: Taxpayers are directly funding more of the operations of the health insurance industry.

The other side: A.M. Best said a larger share of government health care programs poses financial and political risks for insurers due to "a greater reliance on state and federal funding, as well as a growing dependence on federal rules and regulations."

Go deeper

6 hours ago - World

Top general: U.S. losing time to deter China

Stanley McChrystal. Photo: Alex Wong/Getty Images

Stanley McChrystal, a top retired general and Biden adviser, tells Axios that "China's military capacity has risen much faster than people appreciate," and the U.S. is running out of time to counterbalance that in Asia and prevent a scenario such as it seizing Taiwan.

Why it matters: McChrystal, the former commander of U.S. and NATO forces in Afghanistan, recently briefed the president-elect as part of his cabinet of diplomatic and national security advisers. President-elect Joe Biden is considering which Trump- or Obama-era approaches to keep or discard, and what new strategies to pursue.

Progressives shift focus from Biden's Cabinet to his policy agenda

Joe Biden giving remarks in Wilmington, Del., last month. Photo: Roberto Schmidt/AFP via Getty Images

Some progressives tell Axios they believe the window for influencing President-elect Joe Biden’s Cabinet selections has closed, and they’re shifting focus to policy — hoping to shape Biden's agenda even before he’s sworn in.

Why it matters: The left wing of the party often draws attention for its protests, petitions and tweets, but this deliberate move reflects a determination to move beyond some fights they won't win to engage with Biden strategically, and over the long term.

Dave Lawler, author of World
8 hours ago - World

Venezuela's predictable elections herald an uncertain future

The watchful eyes of Hugo Chávez on an election poster in Caracas. Photo: Cristian Hernandez/AFP via Getty

Venezuelans will go to the polls on Sunday, Nicolás Maduro will complete his takeover of the last opposition-held body, and much of the world will refuse to recognize the results.

The big picture: The U.S. and dozens of other countries have backed an opposition boycott of the National Assembly elections on the grounds that — given Maduro's tactics (like tying jobs and welfare benefits to voting), track record, and control of the National Electoral Council — they will be neither free nor fair.