Barack Obama’s signature health-care law is struggling for one overriding reason: Selling mispriced insurance is a precarious business model.
Aetna Inc. dealt the Affordable Care Act a severe setback by announcing Monday it would drastically reduce its participation in its insurance exchanges. Its reason: The company was attracting much sicker patients than expected. Indeed, all five of the largest national insurers say they are losing money on their ACA policies and three, including Aetna, are pulling back from the exchanges as a result.
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An Arizona county is poised to become an Obamacare ghost town because no insurer wants to sell exchange plans there.
Aetna’s recent announcement that it would exit most of the states where it offers Obamacare plans leaves residents of Pinal County, Arizona, without any options to get subsidized health coverage next year, unless regulators scramble to find a carrier to fill the void between now and early October.
About 9,700 people in Pinal signed up for Obamacare plans this year, according to administration data.
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Aetna’s retreat from most ObamaCare marketplaces this week is rippling across rural America, starting with Pinal County in Arizona.
State regulators still have until Aug. 23 to try to lure other companies into the marketplace, but it could be a tough sell after one of the nation’s largest insurers decided to pull back because of costs.
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Last November, when UnitedHealth Group said it expected to post big losses on its Obamacare policies in 2016, rivals such as Anthem and Aetna signaled their Affordable Care Act businesses were doing fine. The Obama administration used that as evidence to refute claims that systemic problems were brewing in its landmark insurance program.
Now, there’s no denying it. The four biggest U.S. health insurers admit they’re each losing hundreds of millions of dollars on their Obamacare plans. Rather than expand coverage, many are pulling out of the exchanges that were set up by the ACA so people can shop for insurance plans, often with the help of government subsidies.
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Aetna’s pullback from the Affordable Care Act’s (ACA) Insurance Exchanges is another bad omen in a growing list. Throughout the controversial history of Obamacare, Aetna has been a stalwart continuing to voice confidence in the future of the program.
Until we are willing to have a conversation about how to fundamentally change a failing program Obamacare is just going to continue to deteriorate. That won’t happen until supporters end their denial and Republicans admit they can’t turn back history.
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After last year’s 4% rate increase, California’s Obamacare insurance exchange rates appear to be catching up to the rest of the country.
The two biggest carriers are raising rates by much more than the average 13.2% increase. Blue Shield said its average increase was 19.9% and Anthem said it would increase rates an average of 17.2%
According to the LA Times, Covered California officials blamed the big increase on the “rising costs of medical care, including specialty drugs, and the end of the mechanism that held down rates for the first three years of Obamacare.”
Well, once again when it comes to Covered California’s explanations, not exactly.
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It is all about the price.
Millions of people buying insurance in the marketplaces created by the federal health care law have one feature in mind. It is not finding a favorite doctor, or even a trusted company. It is how much — or, more precisely, how little — they can pay in premiums each month.
And for many of them, especially those who are healthy, all the prices are too high.
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The health insurance exchanges that are the beating heart of Obamacare are on the edge of collapse, with premiums rising sharply for ever narrower provider networks, non-profit health co-ops shuttering their doors, and even the biggest insurance companies heading for the exits amid mounting losses. Even the liberal Capitol Hill newspaper is warning of a possible “Obamacare meltdown” this fall.
Three states – Alaska, Alabama, and Wyoming – are already down to just a single insurance company, as are large parts of several other states, totaling at least 664 counties.
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Clinton tried hard to get health reform passed when she was first lady in the 1990s. Now that President Obama has done that, she would continue to implement his law if she wins in November. But she has shown a deep interest in more healthcare reform, proposing a number of policies aimed at making coverage more affordable.
Last fall, she released a plan to reduce prescription drug costs that included capping out-of-pocket drug expenses for consumers and requiring pharmaceutical companies to pay larger rebates to Medicare for low-income patients.
In a healthcare proposal on her campaign website, she also calls for requiring insurers to cover more doctors visits even before a patient pays the deductible and providing families with a tax credit to help pay for out-of-pocket health expenses.
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The next president could be dealing with an ObamaCare insurer meltdown in his or her very first month.
The incoming administration will take office just as the latest ObamaCare enrollment tally comes in, delivering a potentially crucial verdict about the still-shaky healthcare marketplaces.
The fourth ObamaCare signup period begins about one week before Election Day, and it will end about one week before inauguration on Jan. 20. After mounting complaints from big insurers about losing money this year, the results could serve as a kind of judgment day for ObamaCare, experts say.
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