Tag Archives: Aetna

Connecticut spiraling into financial despair

dannel malloy

Gov. Dannel Malloy (Demorat)


Odd how high taxes can lead to a financial crisis…
From Fox News: While Illinois Opens a New Window. Connecticut has been under the microscope for its $15 billion backlog of unpaid bills, multi-billion dollar pension crisis and paralyzing political polarization, it is not the only state facing pressure to pass a spending deal by June 30.
The nation’s wealthiest state, Connecticut, is also facing a series of challenges as it remains unable to strike a budget deal with the new fiscal year approaching on Saturday. It is likely the state will enter the new month without an approved two-year budget, but a so-called provisional “mini budget” is still on the table. This last-ditch option includes $300 million to balance out spending cuts the state would be prompted to make in order to keep up with the deepening deficit.
Revenue shortfalls in the state register around $450 million for the current fiscal year alone, while estimated deficit totals are projected to clock in near $5 billion for the 2018 and 2019 fiscal years combined, according to The Connecticut Business & Industry Association. Debt outstanding levels and unfunded pension liabilities relative to revenues are among the highest of any state in the country, Moody’s Investors Service said in May.
As previously reported by FOX Business, income-tax collections are projected to fall Opens a New Window. in fiscal year 2017 for the first time since the recession.
Connecticut’s financial despair comes despite the state government’s approval of one of its largest tax rate increases ever in 2015.
The three major rating firms have downgraded the state’s credit rating in response to the ongoing budget crisis. In its most recent downgrade, which landed Connecticut with the third-lowest rating out of every state behind only New Jersey and Illinois, Moody’s said “the downgrades reflect continuing erosion of Connecticut’s finances, evidenced by the pending elimination of its rainy day fund, growing budget gaps and rising debt levels.”
However, the situation could get worse still.
On Thursday, health insurance giant Aetna announced it would move its Hartford, Connecticut-based headquarters — after more than 150 years in the state — to New York City in late 2018. The company cited a lack of access to talent as one reason it was leaving its Connecticut base, and said Thursday its long-term commitment there will depend on the state’s “economic health.”
Earlier this year, General Electric (GE) announced a similar move, shipping its headquarters from Fairfield, Connecticut to Boston, Massachusetts.
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Aetna drops last 2 state markets under Affordable Care Act

Obama_laughing
Obamacare going as planned. Let’s hope we can get rid of this monstrosity.
From Yahoo: While Republicans rewrite the Affordable Care Act in Washington, the future of the current law has grown hazier with the nation’s third-largest health insurer completely divorcing itself from state-based insurance markets.
Aetna said late Wednesday that it won’t sell individual coverage next year in its two remaining states — Nebraska and Delaware — after projecting a $200 million loss this year. It had already dropped Iowa and Virginia for next year. The insurer once sold the coverage in 15 states, but slashed that to four after losing about $450 million in 2016.
The government-backed marketplaces are a pillar of the Obama-era federal law because they allow millions of people to buy health insurance with help from income-based tax credits. But insurers like Humana, and now Aetna, have been fleeing that market, and the remaining coverage options are growing thin. Other companies like the Blue Cross-Blue Shield insurer Anthem say they are wary of returning without a guarantee that the government will provide cost-sharing subsidies that reduce expenses like co-payments. Those are separate from the tax credits that help pay premiums.
The White House has assured lawmakers it will continue paying the subsidies, but it has offered no long-term guarantee.
About 12 million people bought coverage for this year on the exchanges, and every market had at least one insurer offering coverage. But a growing number were down to one.
Companies are in the middle of figuring out their prices and coverage plans for next year, and insurance experts expect some holes to develop in those marketplaces.
“All it takes is one insurance company to exit, and that can create panic for other insurers and they pull out too,” said Cynthia Cox, a health insurance expert for the nonprofit Kaiser Family Foundation, which studies health care. “Insurers don’t want to be the last one holding the bag.”
The federal law prevents insurers from rejecting patients based on their health, so if competitors pull out, the last insurer may be left covering all the high-cost patients in that market.
Metropolitan or highly populated areas are still expected to draw several insurers. But rural areas may not be attractive to insurers looking to cut losses. They generally have a smaller, older population.
Ultimately, insurers with the most common brand in health insurance, Blue Cross-Blue Shield, will decide the fate of the marketplaces. Many of those plans specialize in individual insurance and have a long-standing presence in their markets. They also are the only remaining option on exchanges in nearly a third of the nation’s more than 3,100 counties.
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Humana to quit Obamacare exchanges in 2018, providing fuel for Trump's 'repeal' efforts

obamacare2
From Yahoo:  While Republicans continue to grapple with plans to repeal and replace Obamacare and stabilize health insurance rates, Humana (HUM) is the first major insurer to say it is dropping out of the individual market for 2018.
“Based on our initial analysis of data associated with the company’s health-care exchange membership following the 2017 open enrollment period, we continue to see further signs of an unbalanced risk pool,” said Humana CEO Bruce Broussard, on a conference call with analysts Tuesday. “Therefore, the company has decided that it cannot continue to offer this coverage for 2018.”
In the wake of the news, President Donald Trump tweeted that the insurer’s decision was another example of the failure of the Affordable Care Act, and he reiterated his plan to “repeal, replace & save healthcare for ALL Americans.”
The health insurer made the announcement with its earnings update, following the mutual termination of its $34 billion merger agreement with Aetna (AET) earlier in the day. The two insurers agreed to part ways , after a federal court judge blocked the deal on antitrust grounds.
Humana now expects to earn $10.80 to $11.00 per share for 2017, excluding anticipated losses on its exchange business.
Humana cut back its Affordable Care Act exchange participation to 11 states last July, when the Department Of Justice sued to block its deal with Aetna. The insurer said that despite efforts to mitigate losses on its exchange plans in 2017 through narrower networks and selective market participation, it is seeing early signs of high pharmacy utilization among its new members.
Right now, the insurer estimated that it will lose a modest $45 million on ACA exchange plans, but it cautioned that this is an early estimate and “a number… that we’re going to have to evaluate.”
Other health insurers have threatened to pull out of the individual market if there is no clarity from Capitol Hill or Trump’s health officials on stabilizing the markets, but Humana is the first to say that it will pull out altogether.
Leading up to 2017 open enrollment, the exchange markets experienced tremendous turbulence last year, after most major insurers, including Humana, cut back on participation after suffering big losses on exchange plans.
Humana is a leading Medicare Advantage plan provider, and executives said that they don’t believe that they can achieve the same kind of health-care models on the Obamacare exchanges that they achieve with health plans for seniors.
The company does not hold out hope for more detail on Republican “repeal and replace” plans in the near term.
“We’re really feeling that this organization needs to stay focused on what we do well,” Broussard said, and the company can’t do that with Obamacare plans. “I think with that particular program, the way it is designed today and most likely the way it is designed in the future, will limit our ability… to get back into that marketplace.”
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Aetna ditching 70% of its ObamaCare business

Obamacare: Going as planned.
tried to warn you
Via NY Post: Insurance giant Aetna won’t be offering coverage under ObamaCare next year in 11 of the 15 states it now serves — an announcement that instantly became an issue in the presidential race.
Aetna’s decision led Donald Trump to charge that President Obama’s health care reform was “imploding.” “Aetna’s decision to leave the Affordable Care Act’s public marketplaces is the latest blow to this broken law that is slowly imploding under its regulatory red tape,” said Trump campaign deputy national policy director Dan Kowalski.
Millions of Americans have lost their health coverage under this disastrous policy, eliminating their ability to choose their doctors. Thousands of businesses have been forced to cut employment or shutter their doors in response to Obama’s signature achievement,” he added.
The company had previously warned that it expected to lose more than $300 million this year on the 900,000 patients it covers under the Affordable Care Act. Aetna said it is pulling out of ObamaCare markets in Arizona, Florida, Georgia, Illinois, Kentucky, Missouri, North Carolina, Ohio, Pennsylvania, South Carolina and Texas.
Aetna does not currently offer the policies in New York. It does offer other medical insurance to individuals and small businesses as well as large employers in the state, officials said. It will continue to offer policies in Delaware, Iowa, Nebraska and Virginia.
ObamaCare is credited with expanding coverage to millions of previously uninsured or under-insured people.
O laughs
But insurers have complained they have lost money on the policies. United Health Group and Humana are other insurers exiting ObamaCare plans.
Aetna CEO Mark Bertolini, in a statement, said there were not enough younger, healthier customers signing up to make ObamaCare policies sustainable. “The vast majority of payers have experienced continued financial stress within their individual public exchange business. Providing affordable, high-quality health care options to consumers is not possible without a balanced risk pool,” Bertolini said.
More than a dozen nonprofit insurance co-ops have shut down in the past couple years. The pullouts could spell trouble because competition is supposed to help control price increases.
Some states like Alaska and Oklahoma will be left with only one insurer selling ObamaCare plans to individuals in 2017. More densely populated states like New York say their ObamaCare markets remain strong.
But rates for customers are skyrocketing to maintain stability.
Obamacare Screw U
Citing increased medical costs, New York recently authorized insurers offering individual ObamaCare plans to increase premiums by an average 16.6 percent — the highest rate hike in the program’s four-year existence. New York’s small businesses will get hit with an average 8.3 percent rate hike.
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Insurers warn Obamacare is unsustainable and expect premiums to rise again

  • ObamaCare to reduce workforce by 2 million full-time jobs? Check.
  • Have to pay back your Obamacare subsidy? Check.
  • Restaurants adding a 3% Obamacare surcharge? Check.
  • Universities nationwide limiting employment to comply with Obamacare? Check.
  • Increase in non-group premiums in nearly all states due to Obamacare? Check.

What else could possibility go wrong?
We’ve been Gruberized
tried to warn you
From the Daily Mail: Health insurers are seriously concerned over the future of Obamacare as many insurers rapidly lose money. Some companies are talking about ditching their participation in the marketplace or dramatically increasing prices – and there is also the threat of a total collapse.
The CEO of insurance provider Aetna says it’s still too early to declare the federal health care program a failure but the company ‘continues to have serious concerns about the sustainability of the public exchanges.’
Analysts had expected the program to become more stable as younger, healthier people purchased insurance, but that is not happening.  A report by insurance company Blue Cross Blue Shield found health insurers gained a sicker, more expensive patient population after the Affordable Care Act expanded coverage in 2014.
Newer customers had higher rates of diabetes, depression and high blood pressure, among other conditions.  They also visited the emergency room much more frequently than people who had private, individual coverage before the law expanded.
Another report, by McKinsey and Company showed insurance companies lost money in 41 states in 2014, in the individual market, which includes Obamacare marketplaces. Blue Cross of North Carolina’s CEO Brad Wilson claimed a loss of $400 million. “There’s not going to be something magical happen that will cause this to turn around,” Wilson said to AOL. 
Researchers caution against drawing broad conclusions about the newly insured based on what amounts to a limited look at a still-evolving health care market. But the numbers show how gaining coverage is only part of a long journey toward the ACA’s other key goals of improving health and slowing cost growth.
‘The coverage is the first step,’ said Linda Blumberg, a health insurance expert at Urban Institute, a nonprofit research organization. ‘Figuring out how to help these folks use medical care in the most effective ways is a real challenge.’
The association compiled its report from dozens of insurers that sell Blue-branded coverage in 46 states and Washington, D.C. It compared claims from newer customers with two populations: people who bought coverage before the law expanded and those who have insurance through an employer. Medical costs for new customers were, on average, 19 percent higher in 2014 and 22 percent higher in 2015 than for customers with employer-based coverage.
obamacare
Health insurers expected their initial wave of patients from the ACA expansion to generate higher-than-normal claims because some of the uninsured had not used the health care system for years and were waiting for coverage to help pay for needed care.
Companies also have struggled initially to add younger consumers who don’t consume as much health care, and they have been hurt by expensive patients who sign up outside regular enrollment windows.
Basic economics also may be behind the higher health care use, since the law lowered care costs by expanding coverage. ‘If you lower the price of anything, people are going to use it more,’ said Blumberg, the Urban Institute expert who did not work on the Blue Cross Blue Shield report.
She added that it is too early to draw firm conclusions about trends in use, and the association’s report doesn’t include insurers that don’t sell Blue Cross Blue Shield plans. That includes prominent exchange participants like the nation’s largest insurer, UnitedHealth Group Inc., Aetna Inc. and Molina Healthcare Inc.
Even so, Blue Cross Blue Shield Association Senior Vice President Alissa Fox said their findings underscore a need for better care management. That means making sure newly insured diabetes patients get regular blood sugar checks, or those with other chronic diseases keep taking their medicine. It also involves basic steps like connecting patients with a primary care doctor and teaching them about preventive care like flu shots that can ward off more expensive treatments.
Many newly insure patients are used to simply waiting until they become very sick and then going to an emergency room, said Dr. J. Mario Molina, CEO of Molina Healthcare. His company offers coverage on public exchanges in nine states. Molina said earlier this year that they have been surprised with how hard it has been to draw new patients into a doctor’s office.
‘They had been uninsured for so long that they didn’t understand that this is what … modern insurance is all about,’ he said. ‘It’s about prevention and getting ahead of problems, not waiting until the last minute.’
Obama-laughs--300x199
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10 states where Lucifercare wipes out existing healthcare plans

O frabjous day! Callooh! Callay! (Lewis Carroll, “Jabberwocky“)

I bring you great tidings of . . . bad news.

The following is culled from Sarah Hurtubise’s article for The Daily Caller, Sept. 28, 2013. I’ve changed certain names (e.g., Obama to Pres. Lucifer; Obamacare to Lucifercare) to indict the guilty.

President Lucifer  famously had promised the American people that under his (un)Affordable Care Act, we can keep our existing healthcare plan. He said:

“If you like your health care plan, you can keep your health care plan!”

and

“If you are among the hundreds of millions of Americans who already have health insurance through your job, or Medicare, or Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have!”

All lies.

Back in 2009, Nancy Pelosi famously said that “we” (Congress) must pass Lucifercare in order that “we” (the American people) find out what’s in it.

The second “we” refers to us plebians, not the first “we” of Congress, because after foisting Lucifercare on us plebians, Congress exempted themselves and droves of privileged others from Lucifercare.

Who's exempt from Obamacare

You’ve got to hand it to that Pelosi. She’s right!

Every day since Congress passed and the POS signed that accursed Act into law, we are finding out the rot that’s in Lucifercare.

Here are ten states where consumers may like their health care plans, but — SURPRISE! — we won’t be able to keep them:

1. California: 58,000 will lose their plans under Lucifercare; another 54% of Californians expect to lose their coverage, according to an August poll. The health plans that have exited California’s Lucifercare exchange include:

  • Aetna, America’s third largest insurer, left in July 2013.
  • UnitedHealth.
  • Anthem Blue Cross‘s health plan for small businesses.

2. Missouri: Patients of the state’s largest hospital system — which spans 13 hospitals including the St. Louis Children’s Hospital — will not be covered by the largest insurer on Lucifercare exchanges, Anthem BlueCross BlueShield. Anthem covers 79,000 patients in Missouri who may seek subsidies on Lucifercare exchanges, but won’t be able to see any doctors in the BJC HealthCare system. (Are you as confused as I am?)

3. Connecticut: Aetna won’t offer insurance on the Lucifercare exchange in its own home state, where it was founded in 1850. The reason? “We believe the modification to the rates filed by Aetna will not allow us to collect enough premiums to cover the cost of the plans and meet the service expectations of our customers,” said Aetna spokesman Susan Millerick.

4. Maryland: 13,000 individuals covered by Aetna and its recently-purchased Coventry Health Care won’t be able to keep their insurance plans if they want Lucifercare subsidies on the exchanges. Aetna and Coventry canceled plans to offer insurance in the exchange when state officials wouldn’t allow them to charge premiums high enough to cover costs.

5. South Carolina: 28,000 people were insured by Medical Mutual of Ohio, SC’s second-largest insurance company, until it decided to leave the state entirely in July due to Lucifercare’s “vast and quite complex” new regulations. Company spokesman Ed Byers said Medical Mutual’s patients would be switched over to United Healthcare plans instead.

Obamacare bureaucratic mazeClick to enlarge!

6. New York: Aetna pulled out of New York’s exchange in late August in an effort to keep their plans “financially viable,” said Aetna spokeswoman Cynthia Michener.

7. New Jersey: 1.1 million Aetna customers are at risk in New Jersey, where the leading insurer also won’t be a part of the exchange.

8. Iowa: Wellmark Blue Cross and Blue Shield, Iowa’s largest health insurer, decided not to offer plans in the Lucifercare exchange. It sells 86% of Iowa’s individual health insurance plans.

9. Wisconsin: Two of the three largest insurers in the state won’t offer plans on the exchange. United Healthcare and Humana patients will have to get a new health insurer to buy insurance on Obamacare exchanges.

10. Georgia: Just five insurers are participating in Georgia’s Obamacare exchange. Medical Mutual of Ohio left Georgia and Indiana as well as South Carolina, due to Lucifercaree regulations. Aetna, along with Coventry, also decided against participating in the George health exchange.

~Eowyn

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