Tag Archives: Health Insurance Exchanges

Aetna’s Bertolini counters accusation of power play against DOJ

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http://www.healthcaredive.com/news/aetnas-bertolini-counters-accusation-of-power-play-against-doj/426236/

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http://www.courant.com/news/connecticut/hc-bertolini-senators-20160912-story.html

  • Aetna CEO Mark Bertolini has responded to a letter from a group of senators who accused the company last week of exiting the majority of its ACA markets as a ploy against the federal government for challenging Aetna’s proposed merger with Humana.
  • Bertolini dismissed the senators’ arguments as”unfounded accusations,” the Hartford Courant reported.
  • Aetna spokesman T.J. Crawford told the Courant the company had not received a response from the senators.

California Moves to Allow Undocumented Immigrants to Buy Insurance

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In a move that is sure to draw the ire of Republicans, California officials are asking the Obama administration this week to approve a plan that would allow undocumented immigrants to buy health insurance on the state’s public exchange.

Officials say that up to 30 percent of the state’s two million undocumented adults could be eligible for the program, and that roughly 17,000 people are expected to participate in the first year, if the plan is approved. But the proposal faces serious hurdles in Washington, where it must be approved by both the Treasury and the Health and Human Services Departments.

During debates over health care in his first term, and again when Congress considered an immigration overhaul in 2013, President Obama made it clear that health insurance subsidies under the Affordable Care Act would not go to immigrants who are living in the United States illegally. And two provisions of the health care law limit coverage to residents who are here legally. But advocates of California’s initiative argue that the plan should be approved under what is known as an “innovation waiver,” which allows states to have provisions of the federal law modified, because no federal dollars will be used to fund the program.

 

While uninsured rate hits historic low, young adults still not sold

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http://www.healthcaredive.com/news/while-uninsured-rate-hits-historic-low-young-adults-still-not-sold/425890/

A survey found adults in states with a federally facilitated marketplace more likely to be uninsured than those in states operating a state-based marketplace or a partnership marketplace. This indicates another way in which states’ support (or lack thereof) for the ACA has impacted their uninsurance rates.

States that resisted the ACA face the biggest hurdles in 2017

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http://www.fiercehealthcare.com/payer/states-resisted-aca-face-biggest-hurdles-2017?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiWmpJMlpEZzFZbVV3WXpSaSIsInQiOiI0dCs1NW9kd0ord0VnTUpDWkgzcUp6VmpOV09JNUpldnBqcTh3eUJNTithQUs5QWc0N1JBbjJRYWZmRVJRN216MjNHQ2tFNGhrQWNON2NwR0dLSkdiVTZTSGxDVEZkNVwvejNoRitlVFpGblU9In0%3D

Document titled "Patient Protection and Affordable Care Act"Document titled "Patient Protection and Affordable Care Act"

States that are set to experience reduced competition in their health insurance exchanges also appear to be the ones that were unwilling to lay the groundwork to create a robust marketplace.

The issues that many states are now facing regarding consumer choice and premium pricingwere predicated by resistance from Republican politicians, who failed to expand Medicaid or conduct the necessary outreach to enroll healthy individuals into marketplace plans, according to the Los Angeles Times. In fact, eight of the nine states that have the fewest plan options next year refused to expand Medicaid and failed to engage in outreach.

“It’s the same basic lesson I tell my kids,” Joel Ario, a former insurance commissioner in Oregon and Pennsylvania, told the newspaper. “If you put the work into something, you will get results. If you just sit on the sidelines and complain, you shouldn’t be surprised if things don’t work out.”

New Commonwealth Fund Report: Latinos and People with Low Incomes Are Most Likely to Be Uninsured, Despite Significant Gains Under Affordable Care Act

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http://www.commonwealthfund.org/publications/press-releases/2016/aug/remaining-uninsured

Latinos Are a Growing Share of the Uninsured

Of the U.S. adult population currently without health insurance, 88 percent is Latino, makes less than $16, 243 a year, is under age 35, and/or works for a small business, according to new Commonwealth Fund survey findings. Half (51%) of the remaining uninsured live in one of the 20 states that had not yet expanded Medicaid at the time of the survey.

The report, Who Are the Remaining Uninsured and Why Haven’t They Signed Up for Coverage?, finds that an estimated 24 million working-age adults were uninsured between February and April 2016, six years after the initial implementation of the Affordable Care Act (ACA) in 2010. According to the report, as the number of people without health insurance declined by 20 million since the law went into effect, the composition of the uninsured population has changed: white adults now represent a smaller share and Latinos a larger share.

“About 26 million Americans have gained coverage through the Affordable Care Act’s marketplaces and Medicaid expansion,” said Sara Collins, Vice President for Health Care Coverage and Access at The Commonwealth Fund and the report’s lead author. “However, millions of people still don’t have health insurance. That means they are likely to go without the health care they need and are at risk of medical debt or bankruptcy if they get sick.”

The study finds that state and federal policies, varying levels of awareness about the health insurance marketplaces, and concerns about affordability are the primary reasons people remained uninsured.

Christie boasts N.J. Medicaid expansion success under Obamacare

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http://www.nj.com/politics/index.ssf/2016/08/christie_medicaid_expansion_report.html

Gov. Chris Christie on Monday boasted the success of expanding the Medicaid program in the state, arguing the “naysayers” have been “proven wrong” and that 566,000 additional New Jerseyans have insurance coverage.

It’s been three years since Christie announced he planned to buck his party and embrace President Obama’s Medicaid expansion under the Affordable Care Act. He was one of only a handful of GOP governors to embrace the changes.

“There were many naysayers,” Christie said during a Statehouse news conference.

“We made a deal with the federal government. If they keep their deal, we’ll keep our part of the deal,” he said. “I am for Medicaid expansion … but I am not for Medicaid expansion at any price.”

There’s a simple fix for Obamacare’s current woes: the public option

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http://www.vox.com/2016/8/18/12520820/public-option-health-care-obamacare

THE REALITY IS THAT COMPETITION AMONG PRIVATE INSURERS HAS NEVER LIVED UP TO THE RHETORIC PUT FORTH BY THE INDUSTRY OR FREE MARKET FUNDAMENTALISTS

This week, Aetna announced it would stop selling insurance plans in all but four Obamacare exchanges, the state-run markets set up under the 2010 Affordable Care Act. Aetna, which now covers more than 800,000 people in 15 exchanges, said it had been hemorrhaging money on the plans. (A fight with the government over an acquisition of the insurance company Humana may have played a role, too.)

Aetna’s exit, following similar departures by UnitedHealth and Humana, means that a growing number of US counties — 20 to 25 percent, according to the Kaiser Family Foundation — now have only a single private insurer offering coverage on the exchanges, a development that essentially eliminates consumer choice. One county in Arizona now has no insurers. Even before Aetna’s decision, more than half of state exchanges had four or fewer insurers, with DC, Vermont, Connecticut, and Rhode Island having only two.

It’s enough to make a frazzled health care consumer in one of those feeble markets wish there were another option — perhaps even (dare one say it?) a public option. Does the phrase ring a bell? That’s the health care policy that some policymakers pushed to include in the 2010 law.

Uwe Reinhardt: Adverse risk selection crippling Obamacare

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http://www.healthcaredive.com/news/uwe-reinhardt-adverse-risk-selection-crippling-obamacare/425182/

  • The ACA has failed to attract enough younger, healthier people to the public insurance exchanges, causing Aetna and other private insurers to exit the market rather than shoulder the costs of sicker people, according to Princeton economist Uwe Reinhardt.
  • To deal with adverse risk selection — where sicker-than-average individuals buy insurance while younger, healthier ones don’t — some payers plan to raise premiums more than 25% in 2017.
  • That will lead even more young, healthy individuals to forego obtaining ACA coverage, creating even greater adverse risk selection, Reinhardt says.

Obamacare CEO Kevin Counihan counterstrikes after Aetna’s ACA exit

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http://www.fiercehealthcare.com/payer/obamacare-ceo-kevin-counihan-counterstrikes-aetna-s-aca-exit

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In the aftermath of Aetna’s ACA exchange exit, which leaves places like Pinal County, Arizona, with no insurers scheduled to offer plans in 2017, Obamacare CEO Kevin Counihan says HHS has already revved up its efforts to recruit insurers to fill in the gaps, according to an interview with Politico.

Insurers, including most recently the Dallas-based insurer Scott & White Health Plan, say sicker, more expensive populations mean they’re losing money on government-created marketplaces. Aetna, Scott & White, UnitedHealth and Humana have all said they can’t afford to keep offering the plans.

This week, Aetna dropped out of 68 percent of the exchanges in which it was operating.

But the insurance market–a market based in risk, after all–will always be dynamic. That was the case even before healthcare reform. “This is the nature of the industry,” Counihan toldPolitico.

According to University of Chicago economist Robert Kaestner, these exits are entirely normal.

“I don’t think it’s a particularly unusual situation where the firms are leaving the market,” Kaestner told Salon. “The fact that firms can leave and enter markets means the markets are, in fact, quite competitive.”

Healthcare Hypocrite of the Week: Aetna’s Mark Bertolini

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http://medcitynews.com/2016/08/hypocrite-aetna-mark-bertolini/?utm_source=hs_email&utm_medium=email&utm_content=33097793&_hsenc=p2ANqtz-8tHuz1OyW0jad1rYHbmCrWm51PA21pdsKB9af25xlqpvHnWr2o1T0b7LutMzmXzy521UtBFmUcZw75t8pNJcQYSG5Uvw&_hsmi=33097793

Mark Bertolini

Mark Bertolini, CEO of Aetna

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.