Democratic presidential nominee Hillary Clinton wants to crack down on rising prescription drug costs. She has made it a pillar of her campaign, the stuff of TV ads and stump speeches. She also has ambitious plans for Alzheimer’s research and other medical science initiatives.
But, even if she wins the White House, Clinton might have to put all that on hold.
A series of setbacks to Obamacare in recent months has raised real questions about the viability of the Affordable Care Act, with three major insurers announcing that they will leave many of the law’s marketplaces next year and others requesting substantial premium increases.
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“If you like your doctor, you can keep your doctor” was President Barack Obama’s signature catchphrase he used to sell the Affordable Care Act to the American people. Now Obamacare’s flagship website, healthcare.gov, no longer even addresses the issue.
Ironically, the section in question was the first public (if indirect) admission by the Obama administration that the president’s promise was less than a “guarantee.” As THE WEEKLY STANDARD first reported in July 2013, the website told consumers that they “may be able to keep your current doctor,” in contrast to the president’s unequivocal statement: “Here is a guarantee that I’ve made. If you have insurance that you like, then you will be able to keep that insurance. If you’ve got a doctor that you like, you will be able to keep your doctor.”
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Long-time Obamacare advocate and Aetna chief executive Mark Bertolini created a political earthquake when he announced his company will drastically reduce its individual public exchange participation next year. Similar announcements by United Healthcare, Humana and even some Blues plans show that Obamacare is failing.
Those who designed this disastrous government intervention into the marketplace now want more disastrous government intervention. Their solution is more taxpayer money for subsidies to individuals and insurance companies and a “public option” government health plan.
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With the fourth open-enrollment period set to begin this fall for the marketplaces set up by the Affordable Care Act, it’s becoming clear that the market for health insurance has not evolved as expected, or hoped.
The market is smaller than projected. The people who have bought health plans overall are sicker than predicted. And health insurers have incurred larger losses than anticipated.
As a result, some large national insurance companies, including UnitedHealthcare, Humana and Aetna, plan to abandon markets across the country next year. And health insurers in Wisconsin are proposing the largest rate increases yet for health plans sold on the online marketplaces throughout the state.
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Increasingly, U.S. consumers may have fewer insurance options under Obamacare.
The latest evidence comes in a study from consulting firm Avalere Health, which examined areas, known as rating regions, that insurers use to set premiums and decide where to offer plans to individuals under the Affordable Care Act.
According to Avalere, 36 percent of the approximately 500 rating regions in the U.S. may have just one health insurer when the 2017 signup season starts on Nov. 1. Another 19 percent could have just two carriers. There was far more competition this year, with about two-thirds of rating areas having three or more health insurers vying for customers’ business, according to Avalere.
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People joked for a while about how insurers were pulling out of Obamacare markets so fast we might end up with areas in which there were no insurers at all. It’s no joke anymore: with Aetna’s massive withdrawal yesterday from the Affordable Care Act marketplace, Pinal County, Arizona, the third most populated county in that state, currently has no insurers selling policies on the Exchange. The issue isn’t so much whether people will be subject to the individual mandate tax of up to 2.5% of their income when there are no policies available; an administration that has no difficulty calling a utility shutoff notice a hardship that excuses one from the individual mandate (whether or not the utility was actually shut off) should have no difficulty declaring the non-existence of any insurance to be grounds for an exemption. The issue is that Pinal County, although a bit of an outlier for now, is a harbinger for fundamental problems with the ACA now manifesting themselves with greater clarity across the country. When an insurer covering over 7% of those in the Exchanges and previously hoping to expand instead drops out, we better look at what is going on.
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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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Tennessee’s insurance regulator approved hefty rate increases for the three carriers on the Obamacare exchange in an attempt to stabilize the already-limited number of insurers in the state.
The rate approvals, while a tough decision, were necessary to ensure that consumers around the state had options when open enrollment begins in November, said Julie Mix McPeak, commissioner of the Tennessee Department of Commerce and Insurance. BlueCross BlueShield of Tennessee is the only insurer to sell statewide and there was the possibility that Cigna and Humana would reduce their footprints or leave the market altogether.
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When Aetna decided last week to drop 70% of its health plans in the Affordable Care Act markets, CEO Mark Bertolini publicly blamed the exits on the poor risk pool, as well as “the current inadequate risk-adjustment mechanism.”
The federal government’s decision to block Aetna’s acquisition of Humana also factored heavily into Aetna’s exchange exodus, as Bertolini warned in a July letter that was obtained by the Huffington Post.
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The Obama administration is moving to end duplicate coverage for tens of thousands of people who are enrolled in Medicaid and simultaneously receiving federal subsidies to help pay for private health insurance under the Affordable Care Act.
In the last few days, consumers around the country have received letters warning, in big black type: “People in your household may lose financial help for their marketplace coverage.”
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