Tag Archives: Aetna

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.”

DCG

 

 

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One-third of US won’t have choice between Obamacare plans in 2017

Going as planned.

obamacare

From MSN: It’s looking like a lot of people are going to have little Obamacare choice next year. One-third of the United States may have just a single insurer to pick from on Obamacare marketplaces in 2017, an analysis released Friday suggests.

Seven entire states are projected to have just one carrier in 2017: Alaska, Alabama, Kansas, North Carolina, Oklahoma, South Carolina and Wyoming, according to research by the Avalere consultancy.

And more than half of the country, 55 percent, may end up having two or fewer insurers to choose from on those government-run exchanges, Avalere said.  “And there may be some sub-region counties where no plans are available,” a report by Avalere on its analysis found.

The findings reflect the effect of announcements this summer that three major insurers — Aetna (AET), UnitedHealth (UNH), and Humana (HUM) — will sharply reduce the number of areas where they will sell individual health plans in 2017 due to financial losses on those plans, as well as the failures of most Obamacare co-op insurance plans.

The analysis relates to the number of insurers in a given “rating region,” not the number of plans available. A single insurer can offer multiple plans at different price points, and at different levels of coverage.

The analysis, which assumes no new plans will enter the markets losing those insurers, is sobering news for many consumers, about 11.1 million of whom are now covered by plans sold on the exchanges.

The Obama administration, when asked about 2017 Obamacare insurance premiums that are on track to be significantly higher than in past years, has repeatedly said that consumers can shop around between plans for better prices. But in areas where this is no or little competition, price shopping will be less of an option.

Pinal County, Arizona, is one place that is, as of now, not expected to have an Obamacare insurer to choose from on the federal HealthCare.gov exchange next year. The county near Phoenix, which has 400,000 residents, has seen two insurers, United Health and Blue Cross Blue Shield of Arizona decided to exit the area.

Avalere noted that in 2016, only 4 percent of rating regions — the geographic areas that insurance plans cover — had just one or fewer insurers offering plans. And only 33 percent of the country had two or fewer insurers.

“Depending on where consumers live, their choice of insurance plans may decrease for 2017,” said Elizabeth Carpenter, Avalere senior vice president. “Some exchange enrollees may need to choose another insurance plan in order to maintain coverage.”

Avalere President Dan Mendelson said that the decrease in competition in Obamacare plans is the result of lower-than-expected enrollment, consumers who are costing insurers a lot in health-care benefits, and “troubled” programs that were intended to reduce the risk insurers face by selling coverage on the exchanges.

Obama_laughing

“Congress and the administration can choose to stabilize these markets and re-establish competition — but only through a consensus process that brings in a brings in a broader swath of the uninsured,” Mendelson said.

DCG

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.

DCG

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

DCG

Health insurance executives say tens of millions *more* Americans will lose their health plans

Obama yucks it upOn June 15, 2009, when Obama was selling his Obamacare to Americans, he promised: “If you like your health care plan, you can keep your health care plan, period.”

As Obamacare began to be implemented, millions of Americans discovered, too late, that Obama had lied, when they were notified by their insurance companies that their health plans had been cancelled. (Go the end of this post for more.)

Obama and the Left then blamed the evil greedy insurance companies for the cancellations, conveniently leaving out the fact that the companies had no choice because those plans were non-compliant with the dictates of the new Obamacare law.

Last Wednesday, May 7, 2014, the House Subcommittee on Oversight and Investigations held a hearing on “PPACA [Obamacare] Enrollment and the Insurance Industry.” (PPACA are the initials of the Orwellian name for Obamacare, the Patient Protection and Affordable Care Act.)

The purpose of the hearing was to ascertain just how many Americans actually have enrolled in Obamacare, as well as who was responsible for the previous round of policy cancellations and who should face blame for the next round.

Six executives of health insurance companies provided testimonies as expert witnesses:

  1. Dennis Matheis, President ofCentral Region and Exchange Strategy, WellPoint, Inc. Wellpoint is an independent licensee of Blue Cross and Blue Shield Association.
  2. Frank Coyne, Vice President of Operations and Chief Transformation Officer, BlueCross BlueShield Association. The BC and BS companies collectively provide health care coverage for 100 million members, one in three Americans, in every U.S. zip code.
  3. Mark Pratt, Senior Vice President of State Affairs, America’s Health Insurance Plans (AHIP), the national association representing health insurance plans. AHIP’s members provide health and supplemental benefits to more than 200 million Americans through employer-sponsored coverage, the individual insurance market, and public programs such as Medicare and Medicaid.
  4. J. Darren Rodgers, Senior Vice President and Chief Marketing Officer, Health Care Service Corporation (HCSC). HCSC does business as Blue Cross and Blue Shield of Illinois, Montana, New Mexico, Oklahoma and Texas, and is the largest customer-owned, non-profit health insurance company in America.
  5. Paul Wingle, Executive Director, Individual Business and Public Exchange Operations and Strategy, Aetna, Inc.
  6. Brian Evanko, President, U.S. Individual Segment, Cigna Corporation
Rep. Cory Gardner

Rep. Cory Gardner (R-Colo)

In the hearing, Congressman Cory Gardner (R-Colo) sought to get to the bottom of the health plan cancellations. He pointedly asked the insurance executives the reason for the cancellations.

On his website, Rep. Gardner reports that “The witnesses [insurance company executives] confirmed that these cancellation notices were sent out due to the President’s healthcare law.”

That is bad enough, but worse is yet to come.

Millions more Americans will see their plans canceled when Obama’s healthcare law is fully enforced.

How can that be?

Simple.

Obamacare has caused insurance companies to cancel the health plans of millions of Americans because of those plans’ non-compliance with Obamacare. But those cancellations are just the tip of the iceberg because persistent malfunctioning of the Obamacare sign-up website, healthcare.gov, led Obama to keep extending the sign-up deadline, as well as a one-year delay in the full enforcement of Obamacare. That one-year delay, in turn, means that there will be more insurance plan cancellations when Obamacare is enforced in full.

To determine how many more Americans will have their health insurance cancelled, Rep. Gardner asked each of the insurance executives this question:

“How many [health insurance] plans do you currently offer that do not meet the [Obamacare] law’s requirement, but you are able to continue offering because of the delay [in Obamacare’s full enforcement]?”

All but one of the executives demure, saying they don’t have the exact figures or hard numbers.

One insurance executive, however, Frank Coyne of BlueCross BlueShield Association, did answer Rep. Gardner’s question: “3.2 million.”

That means if the other five insurance executives had answered Gardner’s question, the total number of Americans who can expect to have their health insurance plans cancelled will be in TENS OF MILLIONS.

One last nugget from the subcommittee hearing.

On June 5, 2008, while campaigning to be President, the POS promised: “In an Obama administration, we’ll lower [medical insurance] premiums by up to $2,500 for a typical family per year.”

This is what Mark Pratt, senior vice president of America’s Health Insurance Plans, said at the House Subcommittee hearing on May 7, 2014:

“One critically important step that Congress can take to make coverage more affordable is to delay and eventually repeal the ACA’s health insurance tax. The health insurance tax began in 2014 and will exceed $100 billion over the next ten years. The tax is set at $8 billion in 2014, and increases by over 40 percent to $11.3 billion in 2015, and to $14.3 billion by 2018. In subsequent years, the tax will increase annually based on premium growth. We are deeply concerned that implementation of the new health insurance tax is undermining efforts to control costs and provide affordable coverage options. An Oliver Wyman study, commissioned by AHIP, has concluded that the health insurance tax alone will increase the cost of family coverage in the individual market by an average of $5,080 over the ten-year period of 2014-2023. This study also estimated that the health insurance tax will increase the cost of family coverage in the small group market by an average of $6,830 over the same ten-year period. […] The findings of the Oliver Wyman studies reinforce our deep concern that the new health insurance tax is having a significant negative impact on the affordability of coverage. To address this concern, we strongly support bipartisan legislation (H.R. 763) to fully repeal the health insurance tax, introduced by Reps. Charles Boustany (R-LA) and Jim Matheson (D-UT). To date, 230 House members have cosponsored this bill, including 30 members of the House Energy and Commerce Committee. We also support – as a short-term solution – separate bipartisan legislation (H.R. 3367), introduced by Reps. Charles Boustany (R-LA) and Ami Bera (D-CA), that proposes a two-year delay in the ACA health insurance tax.”

There are 8 more broken Obamacare promises. Go here to find out what they are.

H/t WND and FOTM’s Miss May

See also:

~Eowyn

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