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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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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Some of the Affordable Care Act’s insurance marketplaces are in turmoil as the fourth open enrollment season approaches this fall, but what’s ahead for consumers very much depends on where they live.

Competition on these exchanges will be diminished next year when three of the nation’s largest health insurers — Aetna, UnitedHealthcare and Humana — will sell individual plans in many fewer markets. So too will several Blue Cross and Blue Shield plans in various states. That’s on top of the 16 nonprofit co-ops that have closed since January 2015.

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Health insurance companies are bailing and co-ops are failing as Obamacare barrels down the road to collapse.

Grace-Marie Turner, president of the free-market Galen Institute, said Aetna’s decision is surprising because the company’s leadership has been so supportive of the Affordable Care Act. But she said the firm, like others, has found it difficult to stay profitable amid rising costs caused by regulations under the law and loopholes that allow customers to game the system.

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Aetna is pulling out of 11 of the 15 states it serves on the Obamacare exchanges. Longtime readers of this column will be unsurprised at the reason: It’s losing substantial amounts of money on its exchange policies.

That’s not necessarily the only reason, of course. Companies in heavily regulated industries — and health care is now probably our most heavily regulated sector outside of nuclear power plants — spend a lot of time engaging in n-dimensional chess games with the various government entities that have jurisdiction over their operations. Public statements and market moves may be exactly what they look like. Or they may be part of a complicated strategy involving some third, fourth or eighth factor that does not, at first glance, appear to be much related.

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Aetna’s decision to pull back from ObamaCare is fueling new questions about the long-term viability of the Affordable Care Act (ACA).

When UnitedHealthcare announced in April that it was leaving most ObamaCare marketplaces in 2017, supporters of the law argued against drawing broad conclusions, calling it one company’s decision.

But since then two other large insurers, Humana and Aetna, have said they are slashing ObamaCare offerings due to heavy financial losses from the plans.

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Canceled health insurance plans, shrinking networks, surging premiums and failed co-ops resulting from President Obama’s 2010 health law are only hiccups compared to Obamacare’s Medicaid expansion.

Unlike other major parts of the law, Medicaid expansion is covering more people than intended. This is terrible news for taxpayers, and it will only get worse with the next economic downturn.

Most of Obamacare’s health insurance coverage gains result from expanding Medicaid–a welfare program previously reserved for the elderly, the disabled, pregnant women and impoverished families with children–to millions of working-age, able-bodied, childless adults. Medicaid expansion is paid for with billions in new federal deficit spending.

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Aetna the nation’s fourth-largest health insurer, just decided to stop offering plans on Obamacare’s exchanges in all but four states in 2017. The firm says that it was losing roughly $300 million per year on these policies. And it projected that its losses would only increase, since the share of covered individuals “in need of high-cost care” was growing, according to CEO Mark Bertolini.

Aetna isn’t the only insurer giving up on Obamacare. UnitedHealth, America’s biggest insurer, will sell plans in just three states next year, down from 34 this year. Humana will offer coverage in just 156 counties in 2017, 88 percent fewer than this year.

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