UnitedHealth May Quit Obamacare in Blow to Health Law

[eridani]

http://www.bloomberg.com/news/articles/2015-11-19/unitedhealth-may-pull-out-of-obamacare-marketplace-stock-slides

The biggest U.S. health insurer is considering pulling out of Obamacare as it loses hundreds of millions of dollars on the program, casting a pall over President Barack Obama’s signature domestic policy achievement.

UnitedHealth Group Inc. has scaled back marketing efforts for plans sold to individuals this year and may quit the business entirely in 2017.

While millions of Americans have gained coverage under Obamacare since new government-run marketplaces for the plans opened in late 2013, in UnitedHealth’s case they haven’t been the most profitable. Customers the company has added have tended to use more medical care. UnitedHealth also said today that some people are signing up for coverage, getting care and then dropping their policies.

“We cannot sustain these losses,” Chief Executive Officer Stephen Hemsley told analysts on a conference call. “We can’t really subsidize a marketplace that doesn’t appear at the moment to be sustaining itself.”

UnitedHealth said it expects as much as $500 million in losses on the Obamacare plans in 2016.

Comment by Don McCanne of PNHP: The Affordable Care Act was designed by the nation’s largest insurers to serve the interests of the nation’s largest insurers. It was almost as if the patients were not much more than a necessary nuisance, required only because an insurance market requires patients to purchase their plans. How is it working out for the insurers?

The largest insurer in the nation - UnitedHealth - has scaled back their marketing of ACA exchange plans and is considering totally exiting the exchanges by the end of next year. Two of the other largest insurers - Anthem and Aetna - have yet to profit from the exchanges and are waiting to see if the exchange business will improve before they decide about the future.

It is no secret what happened. The insurers had to agree to crucial reforms in the insurance market. They had to accept higher cost individuals with preexisting disorders; they had to cover ten categories of health care benefits; they had to limit excess administrative costs and profits by agreeing to minimum medical loss ratios, and they had to submit higher premium increases to insurance regulators for greater public scrutiny.

In other words, they had to agree to market basic insurance products to anyone who was eligible for them. With these requirements, premiums would be unaffordable for all but the wealthy. Thus ACA was crafted to keep premiums down by making lower actuarial value plans the standard - requiring greater cost sharing by patients, though with government subsidies for lower-income individuals. ACA also was crafted to provide government subsidies for the premiums to assist lower-income individuals with the purchase of these plans. That still was not enough so they used the leverage of narrow provider networks to contract for cheaper medical services, and they increased the deductibles, shifting more of their costs to patients.

Guess what. It isn’t working - for the insurers or the patients. Congress dumped on us an administratively complex system that has made it almost impossible for the insurers to offer a product with affordable premiums that still meets the basic plan elements required by the legislation. For the patients, the premiums and deductibles are not affordable for the average family, and they have had to give up their health care choices because of the narrow networks selected by the insurers.

Congress and the Obama administration did this one for the insurers. Yet the insurers are beginning to back out now. That’s just fine because it will allow us to replace them with a financing plan that is designed for patients instead. A well designed single payer national health program would make health care affordable for everyone while returning to them their choices in health care delivery.

[hollysmom]

1. sounds to me more like they don't having to pay out claims and limit their profit to 20%

heck if they can get more and republicans are undercutting the system. why not.

[Hoyt]

2. Not disputing the problems, but I think the medical loss ratio applies to employer group plans too.

In fact, if it's over 50 employees, the loss ratio becomes 85%. Also I think the health benefits and all that, also applies.

Single payer, or at least a public option, would help a lot. But that won't be cheap either.

[eridani]

10. We are already spending more per capita than any other country in the world for worse outcomes

So how to pay for universal health care is just not an issue. As Kucinich said in 2004 "We are already payinf for universal health care--we just aren't getting it."

[Hoyt]

12. Good luck explaining that to people. Check how it went in Vermont.

Not disputing what you are saying, I'm just not as optimistic anything will happen any time soon.

[eridani]

14. Not at the national level. But many states are working for single payer at the state level

Which is something that the ACA provides for.

What you seem to be recommending is to just let insurance companies keep killing and bankrupting people. Any attempt at all to change the conversation will fail, so just don't bother.

[Hoyt]

16. Nope not recommending that. Stating the way it is, as Vermont discovered.

People are stupid, but we aren't going to change that.

[eridani]

17. If we changed people's opinions on marriage equality, we can change them on single payer n/t

[Hoyt]

18. By 2030 if we are lucky.

[eridani]

19. That's what people said about marriage equality ten years ago

Backing off on asking for what you want just delays the process.

[Travis_0004]

3. If they are loosing 500 million a year on thlse plans I dont blame them for pulling out.

[Saphire]

5. I'd like to know what their profits are annualy.

[Travis_0004]

6. Its public information

Go to the SEC website and search for their 10-k, and you can find out anything you want to know about them.

[Erich Bloodaxe BSN]

4. Good riddance.

For exactly the reason you note in the last paragraph. The health insurance industry was pricing itself into non-existence before that last desperate attempt to prop them up with public funding. If that poorly-crafted attempt fails as well, and the industry still collapses, there's nowhere to go but public health insurance.

[magical thyme]

7. status quo was failing. now attempt to prop up status quo is failing. how long before we simply dump

the parasi...er, insurance companies?

[UglyGreed]

8. I'm still in limbo

Last edited Fri Nov 20, 2015, 11:35 AM - Edit history (1)

if they are going to pay for my hospital stay for gallbladder surgery. My shunt for Hydrocephalus and other spinal issues were the reasons for my admission. A Neurosurgical team needed to be available for the surgery just in case because of the shunt tubing plus pumping air into the abdomen could travel up the tube and cause an aneurysm. Of course united said this could of been done as an out patient......

[KentuckyWoman]

9. universal single payer medical care

We will continue to fail at this until we do.

[dembotoz]

11. united sucks

[X_Digger]

13. Fuck UHC. They wait until the 89th day to pay things that are due on day 90.

It took five years after switching carriers to get my credit squared away because the assholes hold onto payouts as long as goddamned possible to get that extra little smidge of interest on the money in the bank. I had collection agencies hounding be because of 'serial delinquency'-- because every goddamned month, UHC would be paying someone a small amount that was owed 89 days ago.

They WILL deny claims that are ABSOLUTELY covered-- until you catch them on it. Fuckers. They can go piss up a rope.

[nationalize the fed]

15. CEO of UnitedHealth Group Stephen J Hemsley made $66 million dollars in 2014

UnitedHealth Group Mulls Losses, Blames Obamacare, But CEO Stephen Hemsley Took Home $66M In 2014

...snip...Since the warning emerged, much attention has focused upon the challenges posed by an ever fluctuating healthcare landscape and the flaws of the Affordable Care Act. Yet in 2014, Hemsley took home more than $66 million in total compensation, and pay for healthcare executives has steadily risen in recent years even as experts have suggested that such pay hurts both insurers and customers.

The $66 million that Hemsley made in 2014 included $45.5 million in exercised stock options. His actual salary of $1.3 million was minimal by comparison. Analysts have said that payment in equity rather than cash can lead to short-term thinking for executives, such as a focus on how to boost share prices...
http://www.ibtimes.com/unitedhealth-group-mulls-losses-blames-obamacare-ceo-stephen-hemsley-took-home-66m-2194436

Short Term Thinking has ruined this country. The health care system isn't just broken, it's a full on train wreck. An utter disaster.



A country that allows a CEO of a company to make $66 million dollars a year from mandated-by-law purchases has completely lost it. And this is the gift to the next generation- mandated payments so some jackass at the top can be helicoptered around to his various properties. Sick.

[TheFrenchRazor]

21. word. nt

[TheFrenchRazor]

20. DakotaCare (my obamacare insurer) is dumping their obamacare patients and doubling my premium

my premium, if i stay with them without the subsidy, which of course there's no way in heck i could afford.

[geek tragedy]

22. So much for the "corporate welfare" claim nt