Kaiser Health News Original Stories

3. Political Cartoon: 'Social Media Directive'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Social Media Directive'" by Kelly Kamowski.

Here's today's health policy haiku:

UNITEDHEALTH GROUP'S FORECAST HIGHLIGHTS INSURERS' MARKETPLACE WOES

They're in 'til they're out
And out 'til they're in... What's next
on the exchanges?

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Health Law Issues And Implementation

4. UnitedHealth Cuts Earnings Forecast, Raises Doubts About Future Participation In Health Law Insurance Marketplaces

This early morning disclosure by the nation's largest insurer highlights the difficulties insurers are having with the marketplaces created by the Affordable Care Act and will fuel concerns regarding the long-term sustainability of the exchanges.

The Wall Street Journal: UnitedHealth Raises Doubts About Its Participation In Affordable Care Act
UnitedHealth Group Inc. said it expects major losses on its business through the Affordable Care Act’s exchanges and will consider withdrawing from them, in the most prominent signal so far of health insurers’ struggles with the health law’s marketplaces. The disclosure by the biggest U.S. health insurer, which had just last month sounded optimistic notes about the segment’s prospects, will sharply boost worries about the sustainability of the law’s signature marketplaces, amid signs that many insurers’ losses on the business continue to mount. (Wilde Mathews, 11/19)

Forbes: UnitedHealth Group May Leave Obamacare Exchanges By 2017
The nation’s largest health insurer said it was “evaluating the viability of the insurance exchange product segment,” pulling back on its marketing efforts for individual exchange products for next year and “will determine during the first half of 2016 to what extent it can continue to serve the public exchange markets in 2017.” The insurer sells individual plans on public exchanges in 24 states and covers more than a half million Americans in these plans. (Japsen, 11/19)

Bloomberg: UnitedHealth May Leave Obamacare Marketplace; Stock Slides
Insurers have struggled to profit from the government-run marketplace created by Obamacare. Anthem Inc. last month said some rivals were offering premiums too low to provide the coverage patients require and book a profit. “We can expect other participants to guide to the same experience,” Sheryl Skolnick, an analyst at Mizuho Securities, said in a note. The Minnetonka, Minnesota-based company “is insulated in part from the exchange issue because it entered late and in a more limited way than peers, and because it has a more diversified business model. We expect the group to get hit harder.” (Tracer, 11/19)

Reuters: Health Insurer UnitedHealth Cuts Full-Year Profit Forecast
"in recent weeks, growth expectations for individual exchange participation have tempered industry wide ... so we are taking this proactive step," UnitedHealth Chief Executive Stephen Hemsley said in a statement on Thursday. ... Other large health insurers including Cigna, Humana, Aetna have said also said that the individual plans they offer could be affected in 2016. (11/19)

In other insurance industry news -

The Wall Street Journal: Shares Of Deal Targets Reflect Regulatory Fear
Shares of some high-profile takeover targets are trading at steep discounts to the prices of deals they signed, showing fissures may lurk in the current deal boom. ... Cigna Corp.’s stock is 22% below the value of Anthem Inc.’s $48 billion offer, while oil-field-services provider Baker Hughes Inc. trades 17% cheaper than the price of its pending $35 billion sale to Halliburton Co.​ ... Meanwhile, there have been signs that regulators take a dim view of some of the big pending deals. They are closely reviewing both Anthem’s deal for Cigna and the $34 billion proposed tie-up of Aetna Inc. and Humana Inc. Together, the two deals would trim the number of big health insurers from five to three. (Hoffman, 11/18)

5. Wide Variation In Plan Prices Pose Challenges For Health Law, Creates Stress For Shoppers

Also, some businesses are factoring in the cost of health coverage to their growth calculations.

The Wall Street Journal: Health-Plan Rates Vary Widely, But Most Popular Have Jumped From 2015
For a snapshot of typical insurance prices for 2016 under the health law, The Wall Street Journal examined choices for a midrange “silver” plan through HealthCare.gov for people who currently have coverage with the most popular insurer in their state. Specific premiums vary based on age, locality, the extent of coverage offered and family size, but pricing trends are generally consistent across plans—including those sold directly to people without using HealthCare.gov. (Radnofsky and Overberg, 11/18)

The Wall Street Journal: Rising Rates Pose Challenge To Health Law
Many people signing up for 2016 health policies under the Affordable Care Act face higher premiums, fewer doctors and skimpier coverage, which threatens the appeal of the program for the healthy customers it needs. Insurers have raised premiums steeply for the most popular plans at the same time they have boosted out-of-pocket costs such as deductibles, copays and coinsurance in many of their offerings. The companies attribute the moves in part to the high cost of some customers they are gaining under the law, which doesn’t allow them to bar clients with existing health conditions. (Radnofsky, Overberg and Armour, 11/18)

The New York Times: Shopping For Health Insurance Is New Seasonal Stress For Many
For 2014, the first year she got health coverage through the Affordable Care Act, Gail Galen chose a plan from a new nonprofit insurer, Oregon’s Health CO-OP. But the price jumped for 2015, so Ms. Galen switched to a policy from a different company, LifeWise Health Plan. Now, with open enrollment for 2016 underway, she is preparing to leap to her third insurer in three years — and stocking up on whiskey, she says, only half in jest, as she braces for another round of shopping on the federal insurance marketplace. (Goodnough, 11/18)

The New York Times: Health Care Law Forces Businesses To Consider Growth’s Costs
Starting in January, the Affordable Care Act requires businesses with 50 or more full-time-equivalent employees to offer workers health insurance or face penalties that can exceed $2,000 per employee. Ms. Hunter, who has 45 employees, is determined not to cross that threshold. Paying for health insurance would wipe out her company’s profit and the five-figure salary she pays herself from it, she said. ... The health care law’s employer mandate, a provision that business groups fought against fiercely, is intended to make affordable health insurance available to more people by requiring employers to bear some of the cost of providing it. (Cowley, 118)

6. Consumers Insured By Illinois' Most Popular Obamacare Provider Face 17% Premium Hike

Also in Illinois, a report finds that 175,000 Chicago residents are eligible for insurance but remain uninsured. Elsewhere, media outlets report on enrollment developments from Florida, Maryland, Texas and Minnesota.

The Chicago Tribune: Blue Cross Premiums Jump More Than 17 Percent In Illinois
Some [Illinois] health care consumers are seeing rate increases of 40 percent or more. Rate increases for the lowest-cost plans in the majority of counties are in the 15 to 20 percent range, according to the Illinois Department of Insurance. Blue Cross is the target of a lot of consumer unhappiness. The state's dominant health insurer raised 2016 premiums an average of 17.8 percent on individual policies sold on or off the exchange, according to HealthCare.gov. (Sachdev, 11/17)

The Chicago Tribune: About 175,000 Eligible But Uninsured In Chicago Area
During the third season of open enrollment under the health care law, the Obama administration has called on Chicago and other cities with large numbers of uninsured to increase their outreach to help people gain coverage. ... In Illinois, more than 300,000 are enrolled in marketplace plans. But that represents only about one-third of those eligible for insurance under Obamacare. In the Chicago area about 175,000 people are uninsured but eligible for insurance. (Sachdev, 11/17)

The Miami Herald: HHS Secretary Burwell Visits Miami To Promote Obamacare Enrollment
With more than a million Floridians signed up for coverage through the Affordable Care Act’s insurance exchange — and nearly as many still uninsured but eligible for some type of plan in 2015 — Health and Human Services Secretary Sylvia Burwell visited Miami on Wednesday to make a hard sell for people to enroll. She toured an enrollment center at Miami Dade College’s Wolfson Campus downtown, met privately with South Florida healthcare leaders and held a press conference where she introduced a Miami small business owner who pays $75 a month for coverage through the exchange. (Chang, 11/118)

The Baltimore Sun: Advocates Find Problems With Lists Of Health Exchange's OB-GYNs
For the second time in a year, consumer advocates have found that the specialists listed as available to those who bought health insurance on the state exchange aren't all that available. When the advocates tried to call the obstetrician-gynecologists in the online directory of insurers' in-network providers, they found the list so outdated that only about 22 percent of the 1,493 practitioners were accepting new patients, performed well-patient visits and had appointments available within four weeks. (Cohn, 11/18)