Some analysts and health policy experts view the move as an effort to compel the Obama administration to make changes. (Julie Appleby, 11/20)
Researchers at the University of Pennsylvania found that Medicaid turned down requests for new expensive drugs to treat hepatitis C 46 percent of the time, while private insurers barred them 10 percent and Medicare 5 percent. (Michelle Andrews, 11/20)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Senior Discount'" by Jimmy Margulies.
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Some view the insurer's Thursday announcement as an effort to compel the Obama administration to ease regulations and tweak certain aspects of the health law.
The New York Times: UnitedHealth Lowers Forecast, Blaming Affordable Care Act
UnitedHealth Group, one of the nation’s largest health insurance companies, stunned investors on Thursday morning when it significantly lowered its profit estimates, placing the blame for an expected loss of hundreds of millions of dollars on selling individual policies under the federal health care law. In light of the losses, the company warned that it was also weighing whether it would continue to offer individual coverage through the online exchanges for 2017. (Abelson, 11/19)
The Wall Street Journal: Biggest Insurer Threatens To Abandon Health Law
The industry’s woes, and broad rate increases aimed at stanching the red ink, are putting pressure on the Obama administration to tweak aspects of the law; the issues also risk pulling the ACA back into the political spotlight. Republicans, who have remained opposed to the health law, quickly jumped on the news. (Wilde Mathews and Armour, 11/19)
Kaiser Health News: UnitedHealth Warns Of Marketplace Exit – Start Of A Trend Or Push For White House Action?
UnitedHealthGroup laid out a litany of reasons Thursday why it might stop selling individual health insurance through federal and state markets in 2017 — a move some see as an effort to compel the Obama administration to ease regulations and make good on promised payments. Those problems, including low participation by healthy people, have led to financial losses, according to UnitedHealth. If not addressed, similar issues could affect other insurers, causing more to exit the market in the coming years, some Wall Street analysts and policy experts said. (Appleby, 11/20)
Modern Healthcare: CMS Determined To Make Full ACA Fallback Payments
The CMS released a memo late Thursday that reiterated the federal agency's desire to pay out risk-corridor payments despite the massive shortfall in the near term. The notice came the same day that UnitedHealth Group, the nation's largest health insurer, said it was seriously considering pulling out of the Affordable Care Act's marketplaces. ... The memo states that if health insurers are still owed money under the risk corridors program for 2016, HHS “will explore other sources of funding for risk corridors payments, subject to the availability of appropriations. This includes working with Congress on the necessary funding for outstanding risk corridors payments.” ... However, the Republican-led Congress more or less tied the CMS' hands on risk corridors last December. The budget bill required the program to be budget-neutral. (Herman, 11/19)
USA Today: UnitedHealth Warns It May Exit Obamacare Plans
The possible move by UnitedHealth Group raises new questions about the viability of President Obama's signature health law and follows the departure of more than half of the non-profit insurance cooperatives this year. If UnitedHealth drops out, consumers would lose one of the lowest-cost plans available in much of the country, and some wonder how smaller insurers could fill the void. “If they can’t make money on the exchanges, it seems it would be hard for anyone,” said Katherine Hempstead, who heads the insurance coverage team at the Robert Wood Johnson Foundation. (Bomey and O'Donnell, 11/19)
The Associated Press: UnitedHealth Cuts Outlook, Casts Doubt on Overhaul Exchanges
Insurers are struggling to attract enough healthy customers into their still-new exchange coverage to balance sicker patients who signed up for coverage quicker because they use a lot of health care. Until that happens, the exchanges won't be a viable, long-term market for these companies, Morningstar analyst Vishnu Lekraj said. (Murphy, 11/19)
Los Angeles Times: UnitedHealth May Dump Obamacare Plans, Putting California Expansion In Doubt
The announcement comes as UnitedHealth is seeking a toehold in California’s Obamacare market — after snubbing the state two years ago. Nationwide, UnitedHealth has more than 500,000 people enrolled on government exchanges out of about 10 million Americans who have signed up. Rivals Anthem and Aetna both have a bigger presence with a combined enrollment of about 1.6 million people. (Terhune, 11/29)
The Washington Post's Wonkblog: UnitedHealth Group Says It Is Scaling Back Efforts In ACA Exchanges
If UnitedHealth were to exit the ACA marketplaces in a year , the immediate impact would be too small to topple the exchanges, according to several analysts. They said the announcement may be more important for what it implies about the ability of even large, well-established insurers to thrive in the marketplaces. (Goldstein and Johnson, 11/19)
Bloomberg: Obamacare's Fate May Rest On Patience Of Insurers Aetna, Anthem
The fate of Barack Obama’s signature health-care law may depend on how long Anthem Inc. and Aetna Inc. are willing to wait before starting to make money off it. The two insurers are on the hot seat now that UnitedHealth Group Inc. appears unlikely to linger as a seller on the Affordable Care Act’s government-run markets. (Tracer, 11/19)
The Fiscal Times: Obamacare May Lose UnitedHealth: Will It Hurt?
Obamacare had been heralded as a potential boon to major insurers, given the millions of new customers it would add to their rolls. It hasn’t worked out that way thus far, at least for UnitedHealth. Though nearly 10 million people bought coverage for 2015 as of June through the federal and state-run Obamacare exchanges, including more than 500,000 who have gotten plans from UnitedHealth, those new enrollees have in many cases been more expensive and less profitable. (Dent, 11/19)
Minnesota Public Radio: UnitedHealth Says Losses May Force It Out Of Obamacare Exchanges
University of Minnesota Health Policy and Management Professor Jean Abraham says UnitedHealth's frank assessment of doing business on public exchanges will attract policy makers' attention. (Zdechlik, 11/19)
Marketplace: Insurance Giant Shakes ACA Tree
Here we go again: another round of ‘Is this the beginning of the end for Obamacare?’ ... That news has shocked many in the industry and has reignited partisan debate about the long-term viability of the law. To ACA opponents, UnitedHealth’s announcement is further proof that insurance sold on the exchanges attracts too many sick and expensive consumers. (Gorenstein, 11/19)
The Associated Press: Stocks End Lower, Dragged Down By Health Care Sector
U.S. stocks closed slightly lower Thursday after spending much of the day wavering between small gains and losses. Several companies reported earnings and outlooks that offered a mixed picture of the economy for investors. Health care stocks were among the biggest decliners, dragged down after UnitedHealth Group cut its full-year earnings forecast. The nation's largest health insurer also raised doubts about whether it will continue to participate in a key piece of the Affordable Care Act. (11/19)
CBS News explores how some of the problems consumers are finding with marketplace plans square with the aspirations of the law. Also in news about enrollment are stories about coverage for some over-the-counter products, the penalties for not having insurance and Connecticut's success in signing up younger adults.
CBS News: Is Anyone Happy With Obamacare's Exchanges?
For naysayers of the Affordable Care Act, the fall may be providing them with a "told you so" moment. The exchanges set up by the health care law were designed to bring choice and transparency to the process of buying health care insurance for Americans who need individual plans. Part of the idea was that the exchanges would sign up young Americans, and those healthier types would help even out the high treatment costs for the exchanges' sickest patients. Reality, however, has given those plans a more sober diagnosis. (Picchi, 11/19)
U.S. News & World Report: What You Don't Know About Your Obamacare Coverage
While President Barack Obama's health care law requires insurance companies to cover some over-the-counter medications and devices, a small catch may be causing some patients to forgo care or spend more money than needed: You have to get a doctor's prescription to avoid out-of-pocket costs. The Affordable Care Act requires that insurers cover 10 so-called essential health benefits, some of which can come with no copay, including methods of contraception and smoking cessation tools approved by the Food and Drug Administration, as well as breast pumps for new moms. ... But because some of these medications or devices are also available over the counter, whether or how health insurance plans can step in to cover their costs can be unclear. (Leonard, 11/19)
CBS News: No Health Insurance In 2015? Get Ready To Pay Up
Under the Affordable Care Act, almost everyone is required to be covered under a health insurance plan, or pay a penalty. And that penalty is set to rise steeply this year. (Martin, 11/20)
The Connecticut Mirror: New Access Health Customers Skew Younger, Lower-Income, So Far
More than 5,400 new customers have bought private insurance through the state’s health insurance exchange since Nov. 1, a group that includes a larger share of young adults and people who qualify for subsidized coverage than the current customer base. (Levin Becker, 11/19)
And in Oregon -
The Oregonian: Fight For Kitzhaber Emails Heats Up With Federal Grand Jury, Oracle
Former Gov. John Kitzhaber's lawyer, Janet Hoffman, did not expect a recent hearing concerning a hush-hush federal influence-peddling investigation of her client would be public. But it was, and now it's on YouTube. The Ninth Circuit Court of Appeals hearing gives new insight into Hoffman's fight to stop the state from turning over emails from the former governor's personal account to federal grand jury. The fight is relevant not just t
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