It’s only Thursday, but it’s probably safe to announce that the winner of Healthcare Hypocrite of the Week is Aetna Chairman and CEO Mark Bertolini. And it’s not because Elizabeth Holmes and Martin Shkreli have managed to stay out of the news for a while.
Despite calling the Affordable Care Act business a “good investment” as recently as April, Bertolini has decided to pull Aetna out of most of the public health insurance exchanges. Initially, he cited the ACA risk pools as being unsustainable — in other words, too many old people with chronic illnesses and not enough young and spry customers to mitigate the risk. But as it turns out his actions may have been prompted by a desire to get even when the insurer didn’t get its way on a business deal.
On Monday, Aetna announced that it was pulling out of public individual insurance exchanges in all but four states. For the 2017 plan year, the Hartford, Connecticut-based insurer will only participate in the exchanges in 252 counties in Delaware, Iowa, Nebraska and Virginia. The reason? The company said it lost $200 million on individual plans in the second quarter and $430 million since the Obamacare insurance mandate took effect in 2014.
Alaska, Alabama, Kansas, North Carolina, Oklahoma, South Carolina and Wyoming, will have only one carrier per region.
As major insurers UnitedHealth, Humana and Aetna — along with smaller insurers like the Scott & White Health Plan in Texas — plan to leave theObamacare insurance markets, the exodus will leave some states without much competition on the exchanges.
A new study by Avalere predicts one-third of the country will have no exchange plan competition in 2017. Seven states: Alaska, Alabama, Kansas, North Carolina, Oklahoma, South Carolina and Wyoming, will have only one carrier per rating region in every region in the state, the Avalere study said.
States divide up their exchange market region into rating areas. Consumers may only purchase plans offered within the rating region in which they reside.
Nearly 55 percent of exchange market rating regions have two or fewer carriers, the Avalere study said.
Aetna warned the Department of Justice in a July 5 letter that it would leave the public exchange market if the agency went forward and blocked its merger with Humana.
“Our analysis to date makes clear that if the deal were challenged and/or blocked we would need to take immediate actions to mitigate public exchange and ACA small group losses,” Aetna CEO Mark Bertolini said in the letter. “Specifically, if the DOJ sues to enjoin the transaction, we will immediately take action to reduce our 2017 exchange footprint.”
The letter to Ryan M. Kantor, assistant chief for litigation in the Antitrust Division, was sent days before the DOJ’s injunction blocking Aetna’s $37 billion merger with Humana, and also Anthem’s planned $54 billion deal with Cigna.
This week, Aetna announced it was exiting the Obamacare-created exchange market in all but four states in 2017, a reduction of its current participation in 15 states.
However, Aetna left the exchange markets after seeing deteriorating numbers in its second quarter results, the insurer said in a request for comment today.
“That deterioration, and not the DOJ challenge to our Humana transaction, is ultimately what drove us to announce the narrowing of our public exchange presence for the 2017 plan year,” Aetna said.
Saying the last goodbye in the dorm parking lot, you realize more than ever that you can’t protect your child from every risk. It’s time to let go.
But back at home, you can assemble a strong financial safety net. Knowing what your current insurance will pay for — and whether you need to buy extra coverage — is a good first step.
Here’s how to evaluate your auto, homeowners, life and health insurance needs as your child heads to college.
Giant insurer Aetna announced this week that it was withdrawing from the Obamacare exchanges in 11 of the 15 states it had been doing business, becoming the third major insurance company to scale back its offerings dramatically in the face of heavy losses. The news led to a chorus of “I told you so’s” from critics of the 2010 healthcare law, who have long predicted that it would collapse under its own weight. But they are confusing the growing pains of a new market with the death rattle of a failing one.
It’s important to bear in mind what Obamacare, formally known as the Patient Protection and Affordable Care Act, set out to do. Over the long term, it sought to improve the quality of healthcare and rein in costs — an ambitious effort that may not yield significant results for years, if ever. In the short term, its goal was to extend insurance coverage to millions of uninsured Americans. To do so, it barred insurers from denying coverage or charging higher rates to those with preexisting conditions, required all adults to obtain coverage and offered subsidies to help poorer households pay their insurance premiums.
These changes reinvented the market for individual policies, which serves those not covered by large employer plans or government-run health programs. No longer could insurers minimize their risk by denying coverage to or gouging those with preexisting conditions. The new subsidies also attracted many previously uninsured people who had no track record to guide insurers on their needs and costs.
The result was a hotly competitive market with winners and, yes, losers. The insurance companies that have done well include those with experience serving low-income communities, as well as those in states such as California that have worked hard to bring young and healthy customers into the market. But Aetna and UnitedHealth, which announced in April that it would withdraw from almost all the Obamacare exchanges it had entered, had previously focused on serving large employers, a much less risky and volatile market.
ring the Olympic Games, the world gazes admiringly upon athletes with preternatural musculature and athletic ability — and then laments every tainted urine test, every revelation of doping. In the mind of the public, this is the problem with anabolic steroids: They undermine fairness in competition between elite athletes.
Damaging the spirit of sport, however, is a minor concern compared with how anabolic steroids impair the health of those who use them — not only Olympians and professional athletes, but also high school football players and rank-and-file weightlifters.
Last month, as more than 100 Russian athletes were banned from Olympic competition for doping, federal investigators revealed that Omar Mateen, who killed 49 people at an Orlando nightclub on June 12, had a long history of steroid use. That detail had a chilling echo: Norwegian killer Anders Breivik deliberately used steroids to fuel his 2011 attack that killed 77 and injured hundreds. It received little attention in the American news media at the time, but Breivik methodically experimented with the drugs and, as documented in his diary, carefully selected the steroid and dose for his “mission.”
These cold-blooded killings should tell us that even the direst health warnings about steroids — damage to the heart, liver, and reproductive system — don’t go far enough. It’s what anabolic steroids do to the brain that can be truly terrifying.
