Aetna cutting back Obamacare involvement
All is proceeding according to predictions:
In a blow to the healthcare law, Aetna ”” one of the largest health insurers in the country ”” announced Monday that it will significantly scale back its presence on the ObamaCare marketplaces next year.
The move comes as a range of insurers have complained of financial losses on the ObamaCare marketplaces.
The company said it will scale back from participating in 15 states this year to just four states in 2017.
“As a strong supporter of public exchanges as a means to meet the needs of the uninsured, we regret having to make this decision,” Aetna CEO Mark Bertolini said in a statement, citing a loss of $200 million in the second quarter.
The Obama administration offered various reasons why this doesn’t reflect on the success of Obamacare, including the fact that the DOJ is trying to block a proposed Aetna merger, and this was seen as a possible bargaining chip by Aetna. But as the article says, a “range of insurers” have had problems with losses under Obamacare. In addition:
The mix of ObamaCare enrollees has been smaller and sicker than expected. Some experts say that insurers also set their premiums too low. Premiums are expected to rise more sharply in 2017, which could help insurers address some of the losses…
Aetna, like other insurers, has also pressed for changes to an ObamaCare program known as risk adjustment and has spoken with HHS about the issue.
Risk adjustment is meant to shift money from insurers with healthier enrollees to those with sicker enrollees to help with costs, but Aetna has said the payments are inadequate and pushed for the government to go further by actually subsidizing insurers through the program.
That change could require action from Congress, though. HHS recently announced it is working on smaller-scale changes to the program, which Aetna called encouraging.
“In the second quarter we saw individuals in need of high-cost care represent an even larger share of our on-exchange population,” Bertolini said. “This population dynamic, coupled with the current inadequate risk adjustment mechanism, results in substantial upward pressure on premiums and creates significant sustainability concerns.”
Insurers have also suffered from a shortfall in a similar program, called risk corridors. Republicans have denounced that program as a “bailout” of insurers and worked to limit the payments through it.
This “risk corridor” situation was reported on here years ago.
lets just say its turning out to be a centrally planned soviet style cluster f*ck
its interesting if you do a search for ACA insurers in news on google…
you get lots of issues…
Column What ails the Obamacare insurance exchanges? (It’s not what you think.)
small companies have advantage over large companies because they can act faster given lack of beuracracy
larger companies cant move so fast, they take much longer to make decisions, but they do have more resources
government is the most moribund on terms of action, and by design, so the idea that congress could react fast enough to adjust a commercial product is inane.. and only something that political narcisists who think the state can do very well, a la soviet style, think otherwise (and sadly, they are the idjits in power)
the Department of Health and Human Services recently announced that it would pay only 55% of what insurers with high-cost patients were owed for 2015.
i guess those big globalists companies that love fascism and saw $$$ now are going WTF…
but you have to love what the press says about the risk corridors..
and the left could not see a problem wiht a plan that relied on all of congress to turn the fed into a piggy bank to make up for bad central planning (is there any other kind???)…
oh, the evil republicans who blocked the illegal use of funds… and its not the dems for relying on the illegal use of funds for their plans? [and yes, illegal, as the constituation has no provisions for providing insurance at the expense of the public… ]
i hate it when journalists ignore how things work to paint an unfair position on things…
the rule was not pointless…
Its only pointless to the communists who wanted the money to pay for things to buy votes.
and the insurance companies may lose their cases, which means, too bad for them for getting into bed with this fascistic approach to domesticating the people into a form of cattle.
and from
Struggling To Stabilize: 3Rs Litigation And The Future Of The ACA Exchanges
Based on preliminary analyses, the 2017 exchanges will have fewer options, larger premium increases, and less generous benefits than any year since the ACA marketplaces came on line in 2014. Congressional intervention has damaged the ACA markets – hurting both insurers that sell health plans and the consumers who purchase them. Perhaps the exchanges will find their footing again, but the difficulties with the 3Rs serve as a stark reminder that ACA implementation remains much harder than supporters anticipated.
in article over article what you get is a boo hoo as to how mean the congress who did this is after the fact in that they dont want to open up the 20 trillio dollar purse strings and let out the money that isnt there.
and on the other side
Health Insurer Wants CMS to Offset ACA Losses
really? that the insurance companies thought that they would get this huge expanded pool… and that they could not lose because the feds would insure profit even if there wasnt any… and that they got into bed with the state, and now find out what? that it would be better to NOT have the state meddle in their business.
this is destrying the economics of the insurance field
a field that both ISLAM and Marxism hates (and so communism and socialism hate)
and last
Column It’s time for the government to play hardball with those whining Obamacare insurers
i love the way it starts out:
oh yeah… an enormous favor… this is akin to stalin claiming how he helped tame obesity in the ukraine during holodomar
and then… and then… and gentlemen and THEN
and then, they started sounding like they were doing business in venezuela
yeah, and welfare people should be grateful that they get to live a life of no work, free food, and so on.. right?
and its the insurers own fault for following MANDATES
this is funny… it also shows that people have no idea how the system used to run, and how its supposed to run now that the whole idea of insurance is nullfied by this form of “insurance”
thats funny as insurance companies have always closed when there was no profit, just as busineses in venzuela close when there is no profit… its a capitalist conspiracy!
even worse, they go on about how HHS has changed rules and things, but HHS has no real power to do that under the constituation and power cant be delegated under the constituation. which is why i laugh at the constiatutional conservatives trying to save something that is aldeady dead.
this is how the soviets decentralized power into the various soviets (councils), which then made law as they saw fit… and could not understand that the making of law is disruptvie ad so, constant tweaking does not make profitable, it makes for trying to stand on a ground that shifts and you cant hold balance as rules change faster than the term to earn
the press that doesnt understand things, says its spite
the company says without the merger, its not big enough to have ecoomy of scale to make the profit… how sad… an impasse..
but the best is how the press says that or implies that aetna has to have losses before it can complain that it has losses… ie. its other areas are in the black and profitable, and so its ACA should work if it takes from those other areas to fund the losing part of the business… in the real world, outside of soviet central planning, they shut down unprofitable lines – not use them to suck profits from other areas… endangering the whole company over time
and then comes the lets fix rube goldbergs wacky machine musings of a journalist who doesnt understand business in general, and insurance in particular [i worked for over 10 years for ISO creating rules and rates for the insurance industry as a whole]
though the big problem is that young people who are not benefiting from obamas end to the recession ticking away at below 1.2% cant pay insurance… and since its state run, it comes before food and rent so guess what they do?
its just one more case of Philip Dru being a great fantasy, but not possible to actually run other than idiots that run large companies who dont know how badly they do… (and politicians whno run government in which it doesnt matter how bad yo udo as long as you can be voted in)
The system before Obamacare may not have been perfect (IMO, because of other previous government interventions), but at least it wasn’t in upheaval.
This is a world-class F***-up, and everybody on the right predicted it. Everybody involved in passing this bill should be jailed.
Matt:
Jailed? How about hung from a lamp post on Pennsylvania Avenue?
Neo:
Yeah — really slow loading.
Another failure by Obama that won’t be pinned on him.
I always find it amusing that politicians and bureaucratss think they know how to provide medical care.
President Clinton’s mantra will be; ‘one more indication that now, more than ever… single payer, guaranteed by the government is the only answer to providing Americans with their unalienable right to affordable health care!’
Art may be more than a bit obsessed with the Soviets and feminism but he’s not always wrong.
“Socialized medicine is the keystone to the arch of the socialist state.” Vladimir Lenin
“We can’t expect the American People to jump from Capitalism to Communism, but we can assist their elected leaders into repeatedly and gradually giving them small doses of Socialism, until they awaken one day to find that they have Communism.” — Nikita Khrushchev
Enormous pressure will be on the GOP, even with double majorities, to work with a likely clinton POTUS to solve the Obamacare problem.
Single payer – no insurance companies – Fannie Mae type organization instead?
Big Maq,
That’s the nub of it, one giant step (1/6th of the economy) further toward the collective.
I know some hospital administrators who were ecstatic at the chance to buy up doctors’ practices and give them orders. They thought they would make a killing (sorry) and were big fans of Obamacare. There was no way it would ever work. It has all the wrong incentives and moral hazard.
What might come out of it is a real market system with cash medical practices. I know quite a few doctors who are dropping ALL insurance AND Medicare and going for low overhead, low stress practice. Most are older and do not have huge student loans.
I met a young woman MD a couple of years ago who is the only geriatric specialist in central Iowa. She quit Medicare because she was being harassed and threatened with prison because she was seeing her elderly housebound patients too often. She quit all insurance , including Medicare, and now accepts Visa and Mastercard. She told me she was making a living and more satisfied with her life.
They may succeed in destroying government medicine.
No one who reads or comments here is surprised by this news.
I’m also not surprised that the progressives are failing to recognize the failure. Their answer will be more government money thrown at it or appointing more administrators to study the problems. It can never be their policy prescriptions. It’s always that it just hasn’t been done quite right. You know, like Communism.
“We’ve got to pass it, to see whats in it” A doctor recent stated that reminds him of a stool sample.
I used to work for Aetna (on the disability side, not health), and Bertolini would periodically blather to us about the importance of the ACA during the run-up to its passage and after. If I’d been in Connecticut, I’d have screamed at him, “Are you iut of your mind?” This is what the big insurers pushed for, and now here we are.
As Instapundit would put it, not just about ObamaCare but also every Democrat/Socialist/Marxist/Communist (but I quadpeat(tm) myself) policy or program, all of which, without exception, eventually, inexorably and inevitably lead to disastrous consequences for the little people, even when said consequences were predicted far in advance by sane people who live in the world of the real –
“UNEXPECTEDLY!”
Push and counter push, it’s a tug-of-war, but probably not a generational tug-of-war. Over some years or decade, the Patient Protection and Affordable Care Act will congeal.
It now is all Conspiracies not Theories…
I blame the enablers.
Mike K:
I too have seen doctors opting out of the insurance business. They just could not tolerate the government telling them how many minutes they could spend with a patient, or what tests they could and could not have done. Some of them have given up medicine entirely and retired to the golf course, some have gone into other lines of medical work like managing a specialty clinic. I wonder how long before the government begins to threaten the licensing of doctors who do what your Iowa friend did — get out of the insurance program and start taking money directly from the patient?
OTOH, I have seen several doctors move from retirement back into the warm nest of Obamacare practices — they check all the boxes in the computer and money comes into their account. This is anecdotal, but I have to say my new physician (I had to find one when my long-time family physician opted to run a wound clinic instead of offering family practice) is one of the latter types. I find him impersonal in the extreme.
The government tells him to ask me geriatric questions even though I exhibit no signs of getting old, so he asks them. I presume those questions yield a quick $50 or something, and they satisfy a bureaucrat in an office somewhere. He does an adequate job, but reminds me of the guys in Jiffy Lube — no personal touch, just checking the fan belts and changing the oil filter while draining the dirty oil.
“I used to work for Aetna (on the disability side, not health), and Bertolini would periodically blather to us about the importance of the ACA during the run-up to its passage and after. If I’d been in Connecticut, I’d have screamed at him, “Are you iut of your mind?” This is what the big insurers pushed for, and now here we are.” – Brian S
The insurance providers seemed all in and very supportive all along Obamacare’s formulation.
This is typical of how power gets used in DC. Everyone is out to cut a special deal for themselves.
The insurance industry probably thought it would be a no lose situation as they negotiated a safety net where they would end up being subsidized for making any loses.
Only, Congress had a say in allocating funds to that and a GOP dominated one put a cap on it (yep, the GOP did something about Obamacare where they could). So, now all the industry’s machinations were for naught.
This all comes to a head in 2017. Unless the trumpist GOP 2.0 now thinks “taking care of everybody” means giving in to subsidizing the industry, or authorizing more subsidies to consumers to entice a larger pool of healthy purchasers.
Good article on this…
https://www.bloomberg.com/view/articles/2016-08-16/aetna-s-retreat-from-obamacare-is-more-than-it-seems
When more people sign up to use a scarce service the predictable result is the price goes up.
http://www.economics21.org/html/obamacare-won%E2%80%99t-lead-universal-coverage-1752.html
Isn’t it great we have had Trump around for the past year to crush almost every news cycle with his latest outrageous and/or idiotic antics?
I was one of the fools who thought Obamacare’s failures would be a big issue in the 2016 election.
Not to worry, though. Trump has a solution:
“I would end Obamacare and replace it with something terrific, for far less money for the country and for the people,” said Trump.
After all, according to Trump healthcare is one of the top three functions of the US government.
Until humans suffer, they will refuse to see the truth. Until humans pay the cost, self deception is all they will want to buy with their cries of “mercy”.
There is no mercy available to those who have obeyed the commandments of evil.
That is not the fault of the world, that is not the fault of government, that is the fault of the human weakness in the human heart.
Let people burn, so that they might be forged anew, better this time.
After all, according to Trump healthcare is one of the top three functions of the US government.
Even Gates and Buffet might not disagree. A 70 yo Democrat has been too long under the temptation of power and evil, to change their stripes, even if they change their parties.
Ymarsakar
You can’t get fresh bananas? Walk in the park? Travel across the country and look out over the Grand Canyon? (if you have the gas money) What’s the angst? Is it worth hundreds of thousands of rotting American women and children in the streets? Will an American re-set nullify your life’s bad choices? financial debt? Is it the will of the Lord? (says who?) This is why Conservatism is collapsing as a force for good.
I always thought that health insurance should be decoupled from employment and that insurers should be able to operate across state lines. A person should be able to choose an insurer and keep it if they change jobs or move to another state. This would mean that young healthy people would contribute and they would not become uninsured when the got older and sick. This would reinforce the idea that people are responsible for their own insurance and that it wasn’t simply a gift from their employer.
When that change in outlook occurs, then you can talk about other reforms.
expat, as a small business person who spends a lot more on employee health issuance than rent, I wish it was decoupled from employment. I’d be able to pay everyone more, and I’d be done with the fact that an older person or one with health issues will increase my rates.
I think we are headed for single payer, unfortunately. When the government screws something up, the default is always it would be better if they just had more control and money.
We are so far down the slope now, it is discouraging at times…
Is it the will of the Lord? (says who?) This is why Conservatism is collapsing as a force for good.
If you can stop Britain’s oppression during the era of the Founding Fathers and avoid a string of wars as a result, be my guest.
Conservatives have often never understood why protecting the US Constitution was a good thing to do. They merely observed the after effects as being good, but they do not understand what makes the USA exceptional. It’s not military power, secular political power, or because of American technological progress.
Is it worth hundreds of thousands of rotting American women and children in the streets?
The current quota is a few million born for profit setups, by Planned Profit. Although they’ve already accomplished the two digit mark. But I suppose that doesn’t count, for people who can ignore what’s outside of their eyes.
After all, what difference does it make that a few die so that evil may be glorified? It made no difference in Benghazi or to the IRS/ATF goons either.