Surprize: Obamacare still a disaster.....

[Sun Devil 92]

From the article:

To be honest, although I have little doubt Aetna was hoping its position on the exchanges would help with the merger, the letter sounds less like extortion and more like a sensible decision that any accountable executives would make when their company is facing losses. The real outrage isn't that insurers like Aetna are abandoning Obamacare, but that companies like Aetna likely participated in Obamacare for cronyistic reasons to begin with.

do you really think anything David Harsanyi writes is evidence of anything? the opinion of a winger writes for the federalist????

no doubt you think he's fair and balanced...

It's so funny you claim to be a lawyer.

You constantly demand "evidence", but never provide any of your own.

The quote from the article is one of several....

But we can go back to the basics:

Aetna pulled out of most of the Obamacare Exchanges.

Can we agree that is taking place ?

 

[Sun Devil 92]

But opening markets up across state (and national) lines is a silly idea, I bet.

Insurers can already enter any market they want. The problem identified here is that in some markets (particularly rural ones) it's not financially attractive to do so and they're voluntarily staying out or leaving. You can "open markets up" all you want, it doesn't change anything if insurers don't have any interest in entering your market.


No out-of-state insurers offer plans in Georgia

A new law that allows Georgians to buy health insurance plans approved by other states was envisioned as free-market solution that would lower prices and increase choices.

So far, the law has failed to produce results: Not a single insurer is offering a policy under the new law.

“Nobody has even asked to be approved to sell across state lines,” Georgia Insurance Commissioner Ralph Hudgens said. “We’re dumbfounded. We are absolutely dumbfounded.”

Please use the entire quote next time:

There is no disputing this, and I am not really sure if the author added that as commentary to his major point wihich is that AZ is back to business as usual calling the existing insurance infrastructure a "cartel".

The exchanges, as I understand it, were only operating in Maricopa county (Phoenix) and were thinking of expanding to Pinal county (Tucson). Tucson is not a rural market.

Of course the large point is that these guys are doing what they've always done......targeted places where they can make money.

Obamacare has not brought competition in. It appears to be making it easier for the existing jerks to make good money offering overpriced plans.

It is a disaster.

 

[Sun Devil 92]

Aetna was losing money in the exchanges.

Is anyone going to dispute that ?

Jake did...but then he is out there where only the short bus runs.

Obamacare is clearly a disaster. In a sane nation, the party that gave us this law would be terminated.

Imagine our nation without the D party...just the thought of it brightens my day.

I don't see Jake's posts.

They are not worth reading.

But someone is actually claiming that Aetna was making money in the exchanges...and is walking away from that ? Give me the post number and I'll take a look.

But, let's be real clear (pardon the pun), Aetna as company is benefiting from the suction Obamacare has created for more expensive plans in the major markets of insurance. That has nothing to do with the exchanges.

The exchanges themselves are a small part of what these companies do....and are a disaster.

The shutting of the co-ops is also a very good indication of it's impotence.

There is a difference......

You can be losing money in the exchanges....

And still be making a fortune overall......

Provided your major business is not in the exchanges.

 

[gipper]

Aetna was losing money in the exchanges.

Is anyone going to dispute that ?

Jake did...but then he is out there where only the short bus runs.

Obamacare is clearly a disaster. In a sane nation, the party that gave us this law would be terminated.

Imagine our nation without the D party...just the thought of it brightens my day.

I don't see Jake's posts.

They are not worth reading.

But someone is actually claiming that Aetna was making money in the exchanges...and is walking away from that ? Give me the post number and I'll take a look.

But, let's be real clear (pardon the pun), Aetna as company is benefiting from the suction Obamacare has created for more expensive plans in the major markets of insurance. That has nothing to do with the exchanges.

The exchanges themselves are a small part of what these companies do....and are a disaster.

The shutting of the co-ops is also a very good indication of it's impotence.

There is a difference......

You can be losing money in the exchanges....

And still be making a fortune overall......

Provided your major business is not in the exchanges.

See post 10.

 

[Sun Devil 92]

Aetna was not a major player and Aetna made money.

The only possible response to anyone claiming ACA is a failure is

JakeStarkey

Let's get this straight.

You have evidence that refutes:

Aetna, which announced it would cut its participation from 778 counties to 242 for the 2017 plan year, is just the latest in a string of similar announcements. The company cited pre-tax losses of more than $430 million on individual products since the exchanges' inception in January 2014, as well as the precedent set by the "more than 40 payers of various sizes" that have also pulled back from the marketplaces.

Among these is UnitedHealth Group Inc. (UNH), which announced it would exit all but a "handful" of states during its first-quarter earnings call in April. The company said it had lost $475 million on the exchanges in 2015; it simultaneously upped its 2016 loss estimates from $525 million to $650 million. Shortly afterward Humana Inc. (HUM) warned that it might also leave some states, meaning that three of the country's "Big Five" insurers are drawing away from the exchanges. All have said they're losing money on them.


Read more: Is the Affordable Care Act Failing? (AET, ANTM) | Investopedia Is the Affordable Care Act Failing? (AET, ANTM) | Investopedia
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Aetna won't expand Obamacare business, may cut it back

The U.S. health insurer, which is losing money on the plans it sells in 15 states to individuals on exchanges created under President Barack Obama's national healthcare law, said it also was looking at whether it should continue to offer the contracts.

That statement is a departure from Aetna's stance at the beginning of the year, when Chief Executive Officer Mark Bertolini said he believed the insurer had an obligation to stick with the public health exchange market.

What has changed, he said, is that patients who signed up for Aetna's exchange plans in 2016 have proved to be much sicker than those who enrolled the year before.

"Because the whole pool is so ill, there's so much utilization, everybody's losing money," Bertolini said in an interview.

Aetna said its exchange-based plans for individuals had a pretax operating loss of $200 million in the second quarter, and it projected the loss from that business would exceed $300 million by year-end. It had initially expected to break even on the plans.

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Please share.

I'll ask gipper to let me know when you've responded.

 

[Greenbeard]

Obamacare has not brought competition in. It appears to be making it easier for the existing jerks to make good money offering overpriced plans.

What are you talking about? You've been arguing in this thread that insurers like Aetna have been paying out more in medical benefits for their enrollees than they've taken in through premiums. That means they've been underpricing their plans.

And it's clear many of them have been. Premiums are significantly below where they were expected to be at this point. Consumers have proven to be extremely price conscious and savvy about shopping in the exchanges, and yes most markets have been competitive. Hence low premiums. In some cases, too low: marketwide, the margin on exchange plans in 2014 was -5%, which means a little additional premium revenue is needed. Prices should be a little higher (Arizona in particular had some of the lowest premiums in the country--too low, it seems). But since premiums are still 20% below expectations, there's still plenty of room to rise to more sound levels and still be way under budget.

Moreover, ACA marketplace SLS plan premiums are still lower in 2016 than individual market premiums were in 2013, on average, and a full 20 percent below where the Congressional Budget Office (CBO) originally projected they would be when they first estimated the impacts of the ACA in 2009.

It's silly to argue that plans are underpriced and then suggest what we really need is more competition to lower the prices further.

 

[Sun Devil 92]

Obamacare has not brought competition in. It appears to be making it easier for the existing jerks to make good money offering overpriced plans.

What are you talking about? You've been arguing in this thread that insurers like Aetna have been paying out more in medical benefits for their enrollees than they've taken in through premiums. That means they've been underpricing their plans.

And it's clear many of them have been. Premiums are significantly below where they were expected to be at this point. Consumers have proven to be extremely price conscious and savvy about shopping in the exchanges, and yes most markets have been competitive. Hence low premiums. In some cases, too low: marketwide, the margin on exchange plans in 2014 was -5%, which means a little additional premium revenue is needed. Prices should be a little higher (Arizona in particular had some of the lowest premiums in the country--too low, it seems). But since premiums are still 20% below expectations, there's still plenty of room to rise to more sound levels and still be way under budget.

Moreover, ACA marketplace SLS plan premiums are still lower in 2016 than individual market premiums were in 2013, on average, and a full 20 percent below where the Congressional Budget Office (CBO) originally projected they would be when they first estimated the impacts of the ACA in 2009.

It's silly to argue that plans are underpriced and then suggest what we really need is more competition to lower the prices further.

Are we talking the market in general or just restricting it to the ACA ?

Unless I am reading things wrong.....

1. Insurance companies are losing money in the ACA exchanges.
2. Insruance companies are making a great deal of money in the rest of the world.

I am not the one arguing that Aetna is losing money in the exchanges. They are the ones making that claim.

Please explain to me the value of a direct comparison of between private plans and those offered on the exchanges.

 

[Greenbeard]

Are we talking the market in general or just restricting it to the ACA ?

Unless I am reading things wrong.....

1. Insurance companies are losing money in the ACA exchanges.
2. Insruance companies are making a great deal of money in the rest of the world.

The "rest of the world" isn't generally commercial insurance. It's government insurance and administrative services provided to employer accounts for a fee.

Most of the 23 million medical members Aetna counts nationwide are not insured by them. 14 million of those members are ASC (administrative services contract), which means they don't take risk on those people--they are not insuring them, some employer is. Of the other 9 million, it's a 60-40 split of commercial insured members (including via the exchanges) to Medicare or Medicaid members.

Indeed, back in February the story was that they're making their money on government (Medicare/Medicaid) insurance, not on private insurance like that sold through the exchanges: Aetna earnings jump on growth in Medicare, Medicaid health plans.

Actually competing to sell private commercial insurance products to consumers in an open market is not the bulk of what most insurers do; not even close. That's part of what's special about the ACA. It's led them to do it more and as it turns out many of them aren't particularly good at it.

I am not the one arguing that Aetna is losing money in the exchanges. They are the ones making that claim.

No, you made the claim that we need more competition to lower the prices of these insurance plans. Which suggests you don't think they're currently underpriced (i.e, insurers aren't losing money selling them).

Please explain to me the value of a direct comparison of between private plans and those offered on the exchanges.

Plans in the exchanges are private plans. They fall under the commercial business line of Aetna's financial statements.

 

[Sun Devil 92]

Plans in the exchanges are private plans. They fall under the commercial business line of Aetna's financial statements.

Bad wording on my part.

I should have said non-ACA private plans.

It still does not change the argument.

 

[Greenbeard]

Bad wording on my part.

I should have said non-ACA private plans.

It still does not change the argument.

Plans sold outside the exchanges still have to be ACA compliant. They're subject to the same rules and reforms as anything sold through an exchange.

The problem that insurers like Aetna face is that they haven't historically competed in a real consumer market and despite the ACA pushing them in that direction they haven't gotten good at it.

They've admitted as much, in last year's Annual Report, Financial Report to Shareholders.

Historically, employers have been our most significant customers. Our direct-to-consumer sales have been limited, and our individual Health Care business has been small relative to the other businesses in our Health Care segment. We are developing and operating and seeking to expand our consumer business, and we are now competing for sales on Insurance Exchanges, which are projected to increase as a percentage of our Health Care business over time.

We also will have to respond to pricing and other actions taken by existing competitors and regulators as well as potentially disruptive new entrants which could reduce our profit margins. Due to the price transparency provided by Insurance Exchanges, when we market our individual and small group health insurance products we face competitive pressures from existing and new competitors (including our vendors) who have lower cost structures. Our competitors may bring their Insurance Exchange and other consumer products to market more quickly, have greater experience marketing to consumers and/or may be targeting the higher margin portions of our business.

We can provide no assurance that we will be able to develop or operate a successful or profitable consumer business or compete successfully or profitably on Public Exchanges or Private Exchanges or that we will be able to benefit from any opportunities presented by Public Exchanges or Private Exchanges. If we do not develop and expand a competitive and profitable consumer business, are not competitive on Insurance Exchanges or are unsuccessful in reducing our cost structure, our future growth and profitability may be adversely affected.

The shift toward competitive consumer markets is exposing some key weaknesses in the big names in health insurance.

 

[The Irish Ram]

Just as "climate change" has nothing to do with climate, and is nothing more than a money grab, so is the case of Obama care. It is another way to get us to reach into our pockets and hand more money over to the global elitists.

Aetna was losing money on the exchanges.

Pure and simple.

So were the others. As will we. I have never had a $5,000 deductable, have you?

 

[Arianrhod]

Just as "climate change" has nothing to do with climate, and is nothing more than a money grab, so is the case of Obama care. It is another way to get us to reach into our pockets and hand more money over to the global elitists.

Aetna was losing money on the exchanges.

Pure and simple.

So were the others. As will we. I have never had a $5,000 deductable, have you?

Did you consider choosing something other than a bronze plan?

 

[Sun Devil 92]

Just as "climate change" has nothing to do with climate, and is nothing more than a money grab, so is the case of Obama care. It is another way to get us to reach into our pockets and hand more money over to the global elitists.

Aetna was losing money on the exchanges.

Pure and simple.

So were the others. As will we. I have never had a $5,000 deductable, have you?

Nope.

 

[Sun Devil 92]

Bad wording on my part.

I should have said non-ACA private plans.

It still does not change the argument.

Plans sold outside the exchanges still have to be ACA compliant. They're subject to the same rules and reforms as anything sold through an exchange.

The problem that insurers like Aetna face is that they haven't historically competed in a real consumer market and despite the ACA pushing them in that direction they haven't gotten good at it.

They've admitted as much, in last year's Annual Report, Financial Report to Shareholders.

Historically, employers have been our most significant customers. Our direct-to-consumer sales have been limited, and our individual Health Care business has been small relative to the other businesses in our Health Care segment. We are developing and operating and seeking to expand our consumer business, and we are now competing for sales on Insurance Exchanges, which are projected to increase as a percentage of our Health Care business over time.

We also will have to respond to pricing and other actions taken by existing competitors and regulators as well as potentially disruptive new entrants which could reduce our profit margins. Due to the price transparency provided by Insurance Exchanges, when we market our individual and small group health insurance products we face competitive pressures from existing and new competitors (including our vendors) who have lower cost structures. Our competitors may bring their Insurance Exchange and other consumer products to market more quickly, have greater experience marketing to consumers and/or may be targeting the higher margin portions of our business.

We can provide no assurance that we will be able to develop or operate a successful or profitable consumer business or compete successfully or profitably on Public Exchanges or Private Exchanges or that we will be able to benefit from any opportunities presented by Public Exchanges or Private Exchanges. If we do not develop and expand a competitive and profitable consumer business, are not competitive on Insurance Exchanges or are unsuccessful in reducing our cost structure, our future growth and profitability may be adversely affected.

The shift toward competitive consumer markets is exposing some key weaknesses in the big names in health insurance.

Competitive market selling "ACA compliant" policies is different than just selling policies.

The federal government has, in effect, set the floor pricing.

When that pricing is still to high be even reasonable....what the helk does being competitive really mean.

 

[Sun Devil 92]

Actually competing to sell private commercial insurance products to consumers in an open market is not the bulk of what most insurers do; not even close. That's part of what's special about the ACA. It's led them to do it more and as it turns out many of them aren't particularly good at it.

Most people and companies are not good at selling CRAP.

That is what the ACA has provided us with......CRAP.

Take away the minimum requirements and I might be more interested in this approach.

Believe me, I am not cheering for our insurance industry.

 

[Arianrhod]

...what the helk does being competitive really mean.

You're advocating competitive pricing without knowing what it means?

 

[The Irish Ram]

The most egregious effects of Obamacare won't hit until after the election. Obomb didn't want to put the election in jeopardy because of the strangling effects of ACA. It is about to get much much worse.
For instance, if you go to the ER and are admitted, then released and you go home, only to get worse and need to go back, they will not let you back in. If they do they will be fined over 100,000+ per any person they need to see twice.

And a warning to those who are admitted for several days. Check your status every day. They are changing patient's status to out patient even though you are still in the hosp. Out patients aren't covered. You get the entire bill.

 

[Arianrhod]

The most egregious effects of Obamacare won't hit until after the election. Obomb didn't want to put the election in jeopardy because of the strangling effects of ACA. It is about to get much much worse.
For instance, if you go to the ER and are admitted, then released and you go home, only to get worse and need to go back, they will not let you back in. If they do they will be fined over 100,000+ per any person they need to see twice.

And a warning to those who are admitted for several days. Check your status every day. They are changing patient's status to out patient even though you are still in the hosp. Out patients aren't covered. You get the entire bill.

You're referring to your specific insurance plan. What you're describing is not the case for every insurer or for every plan under any given insurer.

You seem to have chosen a bronze plan with limited benefits because the premiums were low. From the sound of things, this was your first time having to make this decision on your own rather than relying on an employer-offered plan, and you may not have chosen the best plan for your situation.

But since your goal seems to be to complain and not to find answers, have at it.

 

[westwall]

So nice you posted it twice. It may be a "surprize," but it's no surprise.

You've been among those claiming rather vociferously that it was because poor widdle Aetna was losing revenue. Now you've flip-flopped.

Say something about the "free market" just to round things off.

You claimed it was the best thing since sliced bread. You were wrong. Stop trying to defend the indefensible.

 

[Arianrhod]

So nice you posted it twice. It may be a "surprize," but it's no surprise.

You've been among those claiming rather vociferously that it was because poor widdle Aetna was losing revenue. Now you've flip-flopped.

Say something about the "free market" just to round things off.

You claimed it was the best thing since sliced bread.

Links?