What does it mean when an Insurance Co. Opts Out of Obamacare?

What does it mean when an insurance company Opts Out of Obamacare? Does that mean they can't or won't write insurance in the state? If they're not part of the Obamacare network, what are the ramifications for a policy holder?

Specifically asking because Aetna just announced that in MA they may opt out of Obamacare, and I was simply curious?

There are two provisions of the ACA that are at work here. First, health insurers are free to join or not join the state or federal marketplaces as they see fit. This is usually the case currently when the news reports that a given carrier is "not participating" in a given state.

Second, the ACA requires that all health insurance meet certain standards to remain eligible for favorable tax treatment. The administration delayed this provision until 2015 to allow companies to renew non-compliant policies people already had.

Everyone is still free to buy any policy any company may offer no matter how crappy it is. For example, if next year you want to buy a policy that has a $25,000 annual deductible and does not cover cancer, heart disease, or metabolic disorders; you are free to do that. You just cannot claim the medical insurance premium for income tax purposes. Realistically, only a few hospital indemnity, accident policies and similar policies will survive without being modified to meet the ten standard requirements.
There are large parts of the country where there are or were no exchange coverage policies available, failed state exchanges and other problems stacked up in the IRS and courts. Not being a lawyer I will not speculate on how and when that will change the law but wild cards are probable.

YIKES!
I was considering another approach. Instead of suing to stop ACA because it imposes too much. What if I sue that it doesn't cover EVERYONE with free to low cost health care
as I believe policy should do IF it is going to be universalized by federal govt.

It is not meeting 14th Amendment equal protections but leaving too many people out.

I believe for 100 a month, people could be fully covered if
* spiritual healing were required for all members seek free to low cost coverage
under a universal program (in order to maximize resources and minimalize waste)
* anyone convicted of premeditated crimes, violations or abuses would be required
to pay restitution or buy insurance to cover costs of their misconduct if they can't afford it
(ie only in cases where people commit some crime or violation where this is necessary)
* all people were required to learn conflict resolution, and also financial and property management to maximize their ability to cover their costs and not impose on others
* any and all restitution for crimes or related costs incurred to health and medical expenses, debts and damages to people or property, including administrative costs
would be paid to the victims and/or to the respective states to invest in converting prisons and building more teaching hospitals and medical schools and facilities to serving the public, including housing and health care combined in sustainable business districts.

If people do not believe in the same plan for universal care that I do, we have the right to fund our own plans without conflict or imposition by law. So I ask for equal freedom for people like me of different standards and beliefs than ACA to have equal freedom to fund and develop our own choices for health care, which I recommend organizing by party.
 
What does it mean when an insurance company Opts Out of Obamacare? Does that mean they can't or won't write insurance in the state? If they're not part of the Obamacare network, what are the ramifications for a policy holder?

Specifically asking because Aetna just announced that in MA they may opt out of Obamacare, and I was simply curious?

Do you have a link for that? Because I looked and the closest thing I found was:

Aetna CEO Predicts

Surge in Marketing Spending Among Health Insurers - WSJ.com


By Dennis Berman
Jan. 24, 2014 4:41 a.m. ET
"There will be 75 million retail purchasers of health care by 2020," Mr. Bertolini said during a private interview at the World Economic Forum in Davos. "This is going to be a fundamentally different marketplace than today."

Insurers will "be able to offer much more variability and put affordable policies in the hands of individuals," he said.

Mr. Bertolini said the health-insurance market is likely to evolve similarly to that of auto insurance, where a handful of companies have invested billions in traditional advertising and online marketing. That capital was created, he said, by technological changes that made for more efficient underwriting.
 
I also found this one. It states Aetna faces "significant potential headwinds" in MA but does not mention them pulling out.

http://www.streetinsider.com/Analyst+Comments/Aetna+%28AET%29+PT+Raised+to+$75+at+Cantor+Fitzgerald/9144830.html
February 10, 2014 12:54 PM EST
Cantor Fitzgerald maintained a Hold rating on Aetna (NYSE: AET) and raised its price target to $75.00 (from $65.00).

"We are raising our 2014 EPS estimate, initiating a 2015 estimate and boosting our price target to reflect Aetna's progress over the past year and our enthusiasm for its acquisition of Coventry, which has significantly enhanced its government business," said analyst Joseph D. France.

"Uncertainty about MA rates (preliminary numbers are expected 2/21/14), exchanges, and utilization are significant potential headwinds, but we believe that Aetna's analytical focus positions it well for the market's shift to retail products from consultant-driven large group accounts. We believe that much of the growth in the market over the next few years will be attributable to Medicare, Medicaid, and the growing role of managed care in the treatment of ABD and dual eligibles," he added.

For an analyst ratings summary and ratings history on Aetna click here. For more ratings news on Aetna click here.

Shares of Aetna closed at $66.76 yesterday, with a 52 week range of $46.05-$72.16.
 
I hope I have not strayed too far off topic but given all the concern that the healthcare industry is in great jeopardy because of Obamacare I thought I should relay this dire news.

Deutsche Bank Upgrades UnitedHealth Group Inc.; Raises PT (UNH) - Dividend.com
Deutsche Bank reported on Tuesday that it has boosted its rating on UnitedHealth Group Inc. (UNH)

The firm has upgraded UNH from “Hold” to “Buy,” and has lifted the company’s price target from $74 to $85. This new price target suggests a 14% increase from the stock’s current price of $74.24.

Oh wait, that is not what that said, is it? ;) UnitedHealth Group Inc. is the largest health insurer in the country.
 
Medicare Advantage isn't supposed to be a handout to insurance companies, it's supposed to be their chance to prove they can supply better services at a lower cost to the taxpayer. If asking them to produce better (or equivalent, for that matter) services at (almost) the same cost as traditional Medicare causes them to pullout of Medicare Advantage, what rationale is there for the privatized piece of Medicare in the first place?
 
Got it, thanks to all for answering. It's hard to keep up with all the information swirling around and to know and understand what is correct and what is editorializing.

If you would like a source for accurate information regarding the ACA, just say the word and I will provide a link.

However, the "god help us" comment that you made above in regard to single payer leaves me with the impression that you are not very interested in accurate information.

THis is all the accurate information we need

-Geaux

Obamacare will push 2 million workers out of labor market: CBO

Obamacare will push the equivalent of about 2 million workers out of the labor market by 2017 as employees decide either to work fewer hours or drop out of the job market altogether, according to estimates released Tuesday by the Congressional Budget Office.

The analysis set off a furious debate in Washington.

The White House argued that the reduction is positive because it means Americans will forgo jobs or extra work to stay home with their children or strike out on their own as entrepreneurs. Republicans, however, said the report amounted to an “I told you so” moment and that subtracting the equivalent of 2 million workers can’t be good for the economy.

SEE ALSO: College presidents, corporate CEOs to help Obama in end-run around Congress
The CBO said the number of workers dropping out of the labor force will grow from 2 million in 2017 to 2.5 million by 2024

Read more: Obamacare will push 2 million workers out of labor market: CBO - Washington Times

Giving 2000 workers control of their lives is a good thing.

And the pressure of other workers leaving the no longer need "golden handcuffs of health insurance" provided by their companies will force the companies to become more labor sensitive.

Or are those bad things?
 
If you would like a source for accurate information regarding the ACA, just say the word and I will provide a link.

However, the "god help us" comment that you made above in regard to single payer leaves me with the impression that you are not very interested in accurate information.

THis is all the accurate information we need

-Geaux

Obamacare will push 2 million workers out of labor market: CBO

Obamacare will push the equivalent of about 2 million workers out of the labor market by 2017 as employees decide either to work fewer hours or drop out of the job market altogether, according to estimates released Tuesday by the Congressional Budget Office.

The analysis set off a furious debate in Washington.

The White House argued that the reduction is positive because it means Americans will forgo jobs or extra work to stay home with their children or strike out on their own as entrepreneurs. Republicans, however, said the report amounted to an “I told you so” moment and that subtracting the equivalent of 2 million workers can’t be good for the economy.

SEE ALSO: College presidents, corporate CEOs to help Obama in end-run around Congress
The CBO said the number of workers dropping out of the labor force will grow from 2 million in 2017 to 2.5 million by 2024

Read more: Obamacare will push 2 million workers out of labor market: CBO - Washington Times

Giving 2000 workers control of their lives is a good thing.

And the pressure of other workers leaving the no longer need "golden handcuffs of health insurance" provided by their companies will force the companies to become more labor sensitive.

Or are those bad things?

Look at you all quoting the Bammy/Pelosi/Schumer "Job Lock" bullshit ;)
 
Stocks surge on health-insurer gains - The Washington Post
Monday, February 24, 8:13 PM
The Nasdaq reached a 14-year high, though all three indexes closed off their highs for the day, with the S&P 500 finishing less than a point away from its record close of 1,848.38.

Humana and UnitedHealth Group ranked among the S&P 500’s biggest percentage gainers, with Humana’s stock jumping 10.6 percent, to $113.69, after the company said that the government’s proposed cuts to the private Medicare program appeared to be less than it had forecast. UnitedHealth shares rose 3 percent, to $76.01.

Aetna rose 2 percent to close at $71.80 after giving a 2014 earnings outlook.

No!!! The fools. Don't they know Obamacare is the end of it all. There will be not more healthcare for anyone. We are all dooommed. (Pisst, can I get a couple hundred shares of UnitedHealth before they catch on. ;) )
 
Got it, thanks to all for answering. It's hard to keep up with all the information swirling around and to know and understand what is correct and what is editorializing.

If you would like a source for accurate information regarding the ACA, just say the word and I will provide a link.

However, the "god help us" comment that you made above in regard to single payer leaves me with the impression that you are not very interested in accurate information.

THis is all the accurate information we need

-Geaux

Obamacare will push 2 million workers out of labor market: CBO

Obamacare will push the equivalent of about 2 million workers out of the labor market by 2017 as employees decide either to work fewer hours or drop out of the job market altogether, according to estimates released Tuesday by the Congressional Budget Office.

The analysis set off a furious debate in Washington.

The White House argued that the reduction is positive because it means Americans will forgo jobs or extra work to stay home with their children or strike out on their own as entrepreneurs. Republicans, however, said the report amounted to an “I told you so” moment and that subtracting the equivalent of 2 million workers can’t be good for the economy.

SEE ALSO: College presidents, corporate CEOs to help Obama in end-run around Congress
The CBO said the number of workers dropping out of the labor force will grow from 2 million in 2017 to 2.5 million by 2024

Read more: Obamacare will push 2 million workers out of labor market: CBO - Washington Times

It doesn't say it will COST 2 million jobs Skippy.

Imagine this, you have been stuck in a job you don't like because of the cost of health care. Obamacare comes along so you and your wife quit and you guys start your own business. I just watched this story on TV. This couple has three kids and did just that. They started their own business. That's two the of the two million pushed out of the labor market.

Don't Republicans want people to start their own businesses? They say they do. Obamacare gives them that chance.

But I suspect many Republicans won't be starting businesses. Too stupid.
 
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The international TBTF insurance rules launch later this year. Overseas exposure generally doesn't exist for the exchange firms. Aetna was one of the few exceptions and it is exiting. I wonder what those rules will do to valuations.
 
What does it mean when an insurance company Opts Out of Obamacare? Does that mean they can't or won't write insurance in the state? If they're not part of the Obamacare network, what are the ramifications for a policy holder?

Specifically asking because Aetna just announced that in MA they may opt out of Obamacare, and I was simply curious?

There are two provisions of the ACA that are at work here. First, health insurers are free to join or not join the state or federal marketplaces as they see fit. This is usually the case currently when the news reports that a given carrier is "not participating" in a given state.

Second, the ACA requires that all health insurance meet certain standards to remain eligible for favorable tax treatment. The administration delayed this provision until 2015 to allow companies to renew non-compliant policies people already had.

Everyone is still free to buy any policy any company may offer no matter how crappy it is. For example, if next year you want to buy a policy that has a $25,000 annual deductible and does not cover cancer, heart disease, or metabolic disorders; you are free to do that. You just cannot claim the medical insurance premium for income tax purposes. Realistically, only a few hospital indemnity, accident policies and similar policies will survive without being modified to meet the ten standard requirements.

I'd very much like to see these claims substantiated , citations please?
 

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