Obamacare taking hits from its health care providers

Obamacare taking hits from its health care providers

Back in July, a letter was leaked from Aetna CEO Mark Bertolin to the Justice Department, threatening to scale back their coverage under the Affordable Care Act, ACA, if their merger with Humana was blocked. On Tuesday, after the Justice Department deflected the threat, Aetna announced that “the company move would take it out of 546 counties in 11 states, leaving it active in 242 counties in four states: Delaware, Iowa, Nebraska and Virginia” (Hensley).

This comes in the wake of a dismal June, full of multiple insurers seeking higher premiums for their policies come 2017, due to financial losses attributed to low enrollment in combination with “sicker-than-expected customers” under the ACA (Associated Press).  Health insurance is priced by state so while patients not protected by government subsidies in Texas may face an increase of up to 60 percent, those in North Carolina have only been threatened with an increase of up to 18.8 percent (Associated Press). Those not eligible for protection include those are business owners, self-employed, and early retirees (Associated Press). “"This is going to be a very big disruptor of the market," said Kelly Fristoe, insurance broker. Some relatively healthy people "would probably be willing to roll the dice and take their chances" by dropping coverage, even if it means they might be fined” (Associated Press). While these possible prices increases are troublesome for patients to consider, the threat of their reality may be just what is necessary for a collective legislative overhaul to ameliorate the insurers concerns.

 

References:

Hensley, S. (2016, August). Aetna CEO To Justice Department: Block Our Deal And We'll Drop Out Of Obamacare. Retrieved from http://www.npr.org/sections/health-shots/2016/08/17/490202346/aetna-ceo-to-justice-department-block-our-deal-and-well-drop-out-of-exchanges

Associated Press. (2016, June). Problems for Obamacare: Largest Texas insurer asks big price hike. Retrieved from http://www.cbsnews.com/news/problems-for-obamacare-largest-texas-insurer-asks-big-price-hike/

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