Several of Obama’s fellow Democrats are also considering changes to the Affordable Care Act, including whether to alter the “Cadillac tax”, a levy on high-cost health plans sponsored by employers. Anthem Blue Cross and Blue Shield, for instance, excludes BJC Healthcare System from its Missouri network.
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Thursday’s news that the No. 1 US health insurer, UnitedHealth Group, might withdraw from the health insurance exchanges mandated by so-called Obamacare legislation divided experts into two camps.
Anthem remains committed to the exchanges and to “continuing our dialogue with policymakers and regulators regarding how we can improve the stability of the individual market”, Chief Executive Officer Joseph Swedish said in a statement. For 2016, UnitedHealth sells one of the two lowest-cost silver plans available to more than 40% of the counties in the 38 states that use the federal Healthcare.gov exchange, Levitt said.
“Selecting a health plan can sometimes be confusing, and consumers have questions about which plan is best for them”, Trey Daly, Ohio State Director for Enroll America, said.
Aetna offers policies in 17 exchanges, a number that could grow if it completes a planned merger with Humana.
Aetna is losing money on that business, company CFO Shawn Guertin said at a Credit Suisse health care conference earlier this year.
“The exchange business is unprofitable, ‘”Guertin said”. Instead, we have boosted cash compensation and left employees to make their own arrangements. He said the costs – including deductibles and premiums – were too high for many people, particularly those with few medical needs. The company has already scaled back its marketing efforts for individual insurance policies sold on exchanges for 2016. Shutterstock.com Aetna’s world headquarters in Hartford, Connecticut. Enrollment in 2015 also fell short of initial goals, and insurers say that trend has made it hard to price their plans.
Just last month, UnitedHealth issued a third-quarter earnings report that was much more optimistic about the ACA marketplaces, calling them “a strong viable growth market for us”.
Nichols, Gupte and other analysts agree with the industry’s trade lobby, which says one thing the administration could do is make good on a promise to pay insurers under a temporary program created to redistribute profits from a few insurers that did especially well to offset losses others experienced in the marketplace plans. The move has affected more than 200,000 people here and forced them to scramble for new coverage. Their absence would have the effect of driving premiums even higher in the future, because insurers would need more rate increases to cover the costs of a smaller, sicker pool of enrollees.
Obamacare’s fate may now depend on whether other insurance companies follow UnitedHealth.
The average number of insurers participating in the exchanges has climbed to 10 per state, up from nine past year and eight for 2014, according to the U.S. Department of Health and Human Services. Just when the dust has settled and the health insurers started looking comfortable with the law, new tantrums are being thrown by these players, without whose participation the health care reform will fall apart.
If a GOP candidate wins the 2016 election and Republicans retain the majority in Congress, most investors expect to see Obamacare eventually repealed.
According to the consulting firm McKinsey, insurers lost billions selling ObamaCare plans in 2014, and the losses are mounting again this year. So payments to insurers who have suffered in the market will be cut, unless CMS finds more money for the program.
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There’s turmoil in the individual markets for health insurance.
