‘Obamacare Is Failing’

Obamacare: Premiums And Deductibles Increase, While Choices Vanish

CONNECTICUT: “Deductibles are going to get even higher for some Connecticut residents covered under Obamacare after the Access Health CT board voted Tuesday for a rate increase. Deductibles will increase 25 percent to $5,000 for customers with standard silver plans … A total of 8.5 percent of customers will see their deductibles increase to $4,700, 15.5 percent will rise to $750 …” (“Some Obamacare Customers See Sharp Climb For Deductibles,” Hartford Courant, 2/28/2017)

NEW YORK: “In New York, [Oscar Insurance Corp’s] largest market, the startup has moved to cut costs by working with a smaller set of hospitals and doctors, called a narrow network, a strategy already used in other regions. It also stopped selling in two areas, and boosted premiums significantly.” (“Losses Mount for Obamacare Startup Oscar as Repeal Looms,” Bloomberg News, 2/28/2017)

NEW YORK, CALIFORNIA, TEXAS, AND NEW JERSEY: “Oscar offers insurance in the ACA’s individual market in the New York City area, San Francisco, Los Angeles and San Antonio, and exited the Dallas-Fort Worth area and New Jersey this year. Oscar has raised its premiums about 20 percent in New York, 24 percent in San Antonio and 12 percent in the Los Angeles area.” (“Losses Mount for Obamacare Startup Oscar as Repeal Looms,” Bloomberg News, 2/28/2017)

Obamacare Has Failed To Control Costs

“Spending on prescription drugs for health plans created under the Affordable Care Act increased last year at a rate more than three times that of other commercial plans and most government-run plans managed by Express Scripts Holding Co. Express Scripts, the largest manager of prescription drug plans for U.S. employers, on Tuesday said year-over-year spending per person for individual insurance plans sold on the Obamacare exchanges where it manages the pharmacy benefit rose 14 percent in 2016, driven by higher drug prices and utilization. Express Scripts said per-capita spending for other commercial plans it manages, mostly for employers, rose just 3.8 percent last year … Drug spending for plans the company manages under Medicare … increased 4.1 percent last year while the rise for Medicaid … was 5.5 percent.” (“Obamacare Plans’ Drug Spending Rose Faster Than Other Plans In 2016: Express Scripts,” Reuters, 2/28/2017)

“Oscar Insurance Corp., the startup trying to reinvent medical insurance with its Obamacare-focused plans, lost more than $200 million on the products in 2016 as it heads into a year that may see the undoing of the health law. The company offered plans in four states in 2016 and lost about $204.9 million on premium revenue of $425.9 million, according to filings. The loss widened from $121.7 million in 2015.” (“Losses Mount for Obamacare Startup Oscar as Repeal Looms,” Bloomberg News, 2/28/2017)

• “UnitedHealth Group Inc. and Aetna Inc. and others exited most of their Obamacare business ahead of 2017 to stem losses, which McKinsey & Co. estimates at $8.9 billion industrywide last year.” (“Losses Mount for Obamacare Startup Oscar as Repeal Looms,” Bloomberg News, 2/28/2017)

FLASHBACK: ‘The Past Year Has Been A Rocky One For’ Obamacare

“The past year has been a rocky one for the landmark health reform law. Faced with sicker than expected enrollees, insurers pulled back from the market and hiked premiums.” (“Humana Pulls Out Of Obamacare For 2018,” CNNMoney, 2/14/2017)

• “There have been widespread concerns over the last year that the markets could collapse as insurers raised premiums sharply in the face of more costly than expected patients.” (“Amid Obamacare Uncertainty, Insurance Giant Humana Plans To Leave Marketplaces In 2018,” Los Angeles Times, 2/14/2017)

“Aetna chief executive Mark Bertolini said Wednesday that the Affordable Care Act's exchanges … are in a ‘death spiral.’” (“Aetna Chief Executive Says Obamacare Is In A ‘Death Spiral,’” The Washington Post, 2/15/2017)

• “Bertolini said his company has not decided whether to continue selling insurance in the exchanges in 2018, but it already has exited most of the markets where it previously sold plans, remaining in only four states this year. He said that Aetna is the only insurer left in Nebraska's public exchange.” (“Aetna Chief Executive Says Obamacare Is In A ‘Death Spiral,’” The Washington Post, 2/15/2017)

Just Last Month Another Major Insurer Abandoned The Obamacare Exchanges

“Health insurance company Humana announced Tuesday that it would leave the ObamaCare market in 2018. The insurer said it would offer plans through 2017, but that the market has not stabilized enough to participate next year. Humana said it was losing money from taking on too many sick people without enough healthy people to balance the pools. The decision came after Humana scaled back participation and raised premiums, among other changes.” (“Humana To Drop Out Of Obamacare At End Of 2017,” The Hill, 2/14/2017)

• “The company said in a press release it has tried for the past several years to keep selling policies where it could offer ‘a viable product.’ It said it increased premiums, exited markets and tightened provider networks in hopes of stabilizing its individual market business. But an initial analysis of its 2017 consumer base found that it remained riskier than Humana could tolerate. So the company is exiting all 11 states where it sells individual policies, both on the Obamacare exchange and outside of it.” (“Humana Pulls Out Of Obamacare For 2018,” CNNMoney, 2/14/2017)

• “Humana had already sharply reduced its footprint in the Obamacare exchanges over the past year following financial losses. It sold plans in 156 counties across 11 states in 2017, down sharply from 1,351 counties throughout 19 states the previous year.” (“Humana Becomes First Major Insurer To Quit Obamacare Exchanges,” Politico, 2/14/2017)

“[T]he company is a leading source of coverage in some regions, including Tennessee, which has one of the shakiest markets. The pullout will leave no insurer in 16 Tennessee counties in 2018, according to the nonprofit Kaiser Family Foundation, which is tracking marketplace participation.” (“Amid Obamacare Uncertainty, Insurance Giant Humana Plans To Leave Marketplaces In 2018,” Los Angeles Times, 2/14/2017)

• “Humana is also one of only two insurers in dozens of counties in states like Mississippi and Georgia.” (“Humana To Drop Out Of Obamacare At End Of 2017,” The Hill, 2/14/2017)

Last Year, Two Major Insurers Pulled Back From The Obamacare Exchanges

“Aetna Inc. will withdraw from 11 of the 15 states where it currently offers plans through the Affordable Care Act exchanges, becoming the latest of the major national health insurers to pull back sharply from the law’s signature marketplaces after steep financial losses.” (“Aetna To Drop Some Affordable Care Act Markets,” Wall Street Journal, 8/15/16)

• “Aetna will reduce the number of counties where it sells exchange plans next year to 242 from 778, a dramatic turn that came a few weeks after the insurer said it expected steep losses for the year and would reconsider its participation in the market…” (“Aetna To Drop Some Affordable Care Act Markets,” Wall Street Journal, 8/15/16)

• “Aetna is pulling out of all but four states where it currently sells plans on the Obamacare exchanges for 2017.” (“Aetna Pulling Out Of All But Four State Exchange Markets For 2017,” Politico, 8/15/16)

“UnitedHealth Group said in April it would liquidate all its Affordable Care Act coverage.” (“Aetna’s Obamacare Shock,” Wall Street Journal, 8/2/16)

• “UnitedHealthcare, the biggest health insurer in the United States, said Tuesday that it plans to exit most of the Affordable Care Act state exchanges where it currently operates by 2017. The health insurer had already indicated that it was dropping coverage of the plans, more commonly known as Obamacare, in Arkansas, Georgia and Michigan. But during a conference call with analysts Tuesday, CEO Stephen Hemsley noted that ‘next year we will remain in only a handful of states.’” (“Unitedhealthcare To Exit Most Obamacare Exchanges,” CNN Money, 4/19/16)

“Anthem Inc. said it is now projecting losses on its Affordable Care Act plans this year, a turnaround for a major insurer that had maintained a relatively optimistic tone about that business…. Anthem Chief Executive Joseph R. Swedish said that the insurer will re-examine its full-on commitment to selling plans on the health law’s exchanges. Anthem will take a “prudent” approach to its future offerings, he said. Anthem has been a major player in the ACA marketplaces, with 923,000 exchange enrollees, and it offers the plans throughout the 14 states where it is a Blue Cross Blue Shield insurer.” (“Anthem Projecting Losses On Affordable Care Act Plans This Year,” Wall Street Journal, 7/27/16)