Another Health Insurer Threatens to Quit Obamacare After Losses

Olive Rios
February 16, 2017

Coffman said he supports keeping aspects of Obamacare like coverage for the low-income Americans who got access under the Medicaid expansion and coverage for people with pre-existing conditions.

He said that Aetna's heaviest utilizers of health care - the top 1 percent to 5 percent - are driving half of the costs in the exchanges.

But the company said that in reviewing data from 2017 enrollment on the exchanges, it saw "further signs of an unbalanced risk pool".

President Donald Trump took to twitter to voice his thoughts on Humana's exit.

Humana Inc says that the problem with selling individual commercial medical coverage through the ACA was that it never stabilized.

With a new administration in Washington, it's widely accepted that the Affordable Care Act (ACA), otherwise known as Obamacare, isn't likely to survive in its current form. The White House appears to be offering insurers a reprieve while Congress attempts to coalesce around a plan to replace the Affordable Care Act. Faced with sicker than expected enrollees, insurers pulled back from the market and hiked premiums. However, deductibles and premiums seem to have risen in the last few years.

"We anticipate this change could improve the risk pool because it would reduce opportunities for adverse selection by those who learn they will need services in late December and January; and will encourage healthier individuals who might have previously enrolled in partial year coverage after December 15th to instead enroll in coverage for the full year", the rule states.

In the wake of the news, Trump tweeted the decision was another example of the failure of the Affordable Care Act.

The proposed rule, issued Wednesday, is aimed mainly at quelling insurers' concerns and stabilizing the marketplace for 2018.

Companies who offer their full time (working 35 or more hours a weeks) employees insurance would no longer allow them to keep their children on their plan until the age of 26.

Rep. Evan Jenkins, R-W.Va., said the Obama administration, by comparison, had a "lock-down attitude" and was not open to changing the law. They plan to announce whether they will continue in the spring, which is when carriers have to file their policies and premiums for 2018 with state regulators.

But, McPeak said, she is hopeful that Humana might agree to stay in East Tennessee next year.

Citing "further signs of an unbalanced risk pool" based on an early analysis of their 2017 exchange enrollees, Humana executives said - as part of a statement addressing the demise of their planned merger with Aetna - that they can not continue offering individual commercial plans despite adjusting their product and geographic strategies in recent years. Just hours later Cigna said it's calling off its $54 billion deal with Anthem.

The news came as part of a "strategy" memo, following the news that after their loss in court, Humana and Aetna were officially walking away from their plans to merge.

Other reports by Click Lancashire

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