Tag Archives: Humana

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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Rising Obamacare premiums anger those paying full price

We tried to warn you.

electionshaveconsequences

From CNN Money: Shela Bryan, 63, has been comparing prices for individual health insurance plans since May, and she can’t believe what she sees. “They cost a thousand, $1,200 [a month], and they have a deductible of $6,000,” she said. “I don’t know how they think anyone can afford that.”

Bryan, who lives in Hull, Georgia, a hamlet of about 200 residents near Athens, was on her husband Tony’s insurance plan for decades. When Tony died in 2013, she continued his workplace coverage through COBRA, and she had to pay almost the full price of the insurance — about $800 a month. That was high, but it was “the Cadillac of insurance,” Bryan said, with low copays, prescription drug coverage and a $500 deductible. That option will run out in a few months.

Obamacare Screw U

So she is turning to the individual insurance marketplace in what is shaping up to be the most expensive year for the 400,000 or so consumers in Georgia who buy individual policies but don’t purchase them on the Obamacare exchanges.

About 10 million Americans buy individual insurance coverage either on or off the exchanges and get no federal subsidies to help bring down the cost, according to the Congressional Budget Office. About the same number get the financial assistance for the plans they purchase on the exchanges.

“For those receiving subsidies, the subsidy protects them against the increase. If they’re not eligible, they’ll be paying a lot more. And the more premiums go up, the higher the cliff,” said William Custer, a health policy and insurance expert at Georgia State University.

In Georgia, consumers who don’t get insurance through their employers or don’t qualify for tax credits to help pay for policies they purchase are facing double-digit premium increases. Blue Cross Blue Shield of Georgia, the only insurer offering plans throughout the state, received an increase of more than 21% from the state insurance commissioner. Humana was awarded a 67.5% hike.

Numbers like those are rattling other states too. BlueCross BlueShield of Tennessee was granted a 62% rate hike, while state officials approved a 46% increase for Cigna. Florida authorities gave plans there an average 19% bump. And last week, Minnesota officials announced that premiums for the seven insurers on the individual market are rising 50% to 67%.

The insurers are now adjusting for some miscalculations, said Graham Thompson, executive director of the Georgia Association of Health Plans. “The prices are up this year, but our hope is that things will settle down after this year,” he said.

While consumers have faced sticker shock, the insurers have faced what might be called “sicker shock,” which has sent their prices spiraling. They are adjusting premiums after finding that the pool of clients buying plans on the individual market were sicker and more costly than expected when the health law was implemented.

Judge Judy shakes head rolls eyes

Almost two-thirds of Americans get their coverage from plans offered through their workplaces. But those who don’t can buy either on or outside the health law’s marketplaces, also called exchanges. Those with marketplace coverage who earn up to 400% of the federal poverty level — $47,520 for an individual — are entitled to a subsidy, and federal officials say most will pay less than $75 a month for insurance.

Policies sold off the marketplaces must still meet health law standards and the same prices as plans offered on the exchange, according to Linda Blumberg, a senior fellow at the Urban Institute. Federal and Georgia officials note that customers can change plans each year to find a better price, but that also can result in higher deductibles and may force a change in doctors to stay in network.

Bryan, a maintenance supervisor who makes just over the $47,520 limit for a subsidy, finds herself in that market now. She could end up paying as much as $14,000 in premiums for a pared-back policy the likes of which she had never imagined, she said, with no coverage for her asthma and high blood pressure medications. The cheapest policies amount to more than a quarter of her yearly income, or double her mortgage, she noted.  That total package would increase her premiums $4,400 over what she is paying for her COBRA plan and raise her deductibles by $5,800. And that was based on 2016 premium prices.

The federal Department of Health and Human Services announced Tuesday that as many as 2.5 million nationally may be eligible for a subsidy and not know it.

Bob Laszewski

Bob Laszewski

Bob Laszewski, a health policy strategist in Washington, D.C., said the Obama administration and health care advocates need to listen to the complaints of the those who do not receive assistance.

“These people are invisible,” Laszewski said. The ACA “is working very well for lower income people, but the Obamacare supporters missed the fact that if you’re raising a family of four on $100,000, you’re not rich. This is the … guy who remodeled your house, who drives a pickup truck and he’s wearing a Trump hat.”

insult-my-intelligence

DCG

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

Humana pulls out of ObamaCare exchange plans

Going as planned…

obamacare

Via NY Post: Count it as another nail in ObamaCare’s coffin: Humana, one of the country’s top insurers, announced Thursday that it’s pulling out of ObamaCare exchange plans in all but a few states next year.

It will offer policies in “no more” than 11 state marketplaces, down from 19. The numbers don’t add up: Humana took nearly $1 billion in losses from the coverage this year. This follows the exit from the exchanges of such other giants as Cigna and UnitedHealth Group, also after outsized losses.

It’s the much-feared “death spiral”: Too many older, sicker folks are resorting to ObamaCare policies, and not enough younger, healthy folks. So the average enrollee is running up higher bills than the insurers expected — and raising rates will only scare away even more lower-cost customers.

Meanwhile, the Obama Justice Department is moving to block health-insurer mergers — including an Anthem-Cigna deal as well as Aetna’s bid to buy Humana. Why? As The Post’s Josh Kosman reports, the “move would be a blow to the president’s state-focused ObamaCare.” The White House fears the mergers would give the combined firms too much power to set rates, limiting consumer options.

Funny: The ObamaCare law encourages lots of other anti-competition mergers, of hospitals and other providers, in the name of “efficiency.” And doctors across America are giving up on traditional independent practices — as the law pushes them to do. And countless people stuck buying policies on the exchanges have been shocked at how limited their options — like choice of doctor and hospital — turn out to be.

President Obama and Hillary Clinton both used to pooh-pooh the idea of a “public option”: Government-run health insurance that’s just a step away from European-style socialized medicine. But ObamaCare’s woes have pushed both to start suggesting it may be the only answer after all.

The only answer, that is, besides replacing ObamaCare with a truly market-based system that still helps the less fortunate, but doesn’t try to dictate everything from Washington.

DCG

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