United Health may stop offering ACA Exchange plans

[MichaelB]

Will UHC still have Medicare policies next year? I have been looking for this answer in this thread. The reason I am asking is I was planning on getting a UHC plan when I join Medicare in September. I don't want to get a plan that will be dropped.

The UHC announcements are limited to individual ACA policies for people less than age 65. There have been no announcements by UHC (or anyone else) about Medicare policies. Doubtful they would stop selling Medicare policies, they are much more important sources of revenue and profit.

 

[MBSC]

Will UHC still have Medicare policies next year?

Yes, this line of business is profitable. UHC's actions mostly impact their on-exchange plans. In a few states, they are also exiting the off-exchange individual under age 65 market and small group market.

So Medicare plans are following the ACA plans and severely shrinking their networks of doctors, clinics, labs, and hospitals?

Medicare supplements (Medigap) do not have a network per se. If the provider accepts Original Medicare and is accepting new Medicare patients, you are good. Medicare Advantage uses PPO and HMO networks. On average, these networks are getting smaller but it depends on the insurer and state.

Which isn't a big deal if you're getting a subsidy, right? If the price of the SLCSP goes up then your subsidy increases in lock step.

Right, and some younger people would qualify for a subsidy as explained in the article below.

ACA insurance marketplaces: Evaluating market growth - Milliman Insight

2. Premium increases and market bifurcation. The ACA permits individuals with annual household incomes between 100% FPL and 400% FPL, who do not qualify for other forms of minimum essential coverage, to receive premium assistance through the insurance marketplace. This is conditioned on the premium of the subsidy benchmark plan costing more than a certain percentage of an individual’s household income. To the extent the subsidy benchmark plan costs less than the maximum amount the individual must pay under the ACA, the value of premium assistance is $0. This results in the value of premium assistance reaching $0 well below 400% FPL for younger individuals in many states.

As Figure 2 indicates, in many states experiencing large premium increases, the population qualifying for premium assistance was expanded to higher income levels.

Premium increases over time may result in a much greater proportion of younger adults becoming eligible for premium assistance in the marketplace.

 

[ivinsfan]

Which isn't a big deal if you're getting a subsidy, right? If the price of the SLCSP goes up then your subsidy increases in lock step.

I'm on UHC's silver plan in NC (as is my MIL) and we'll be losing that coverage in 2017 it seems. Down to Aetna and BCBS (though the latter has grumbled about pulling out). Both seem like reasonable choices, and if I'm paying the same premium based on % of income I suppose I'm indifferent if the policy costs $1100/mo or $5000/mo (assuming price goes up with less competition).

This is a true statement, but in reality ever escalating health care costs will eventually have a negative effect on everyone in the entire country. It's scary to think about where things might be with healthcare in even another 5 years.My DH is on Medicare and I am 30 months away from it..( and I am counting the months....but that doesn't erase my concern about this problem.

 

[GTFan]

Agreed, especially when you consider that with our current political impasse it may take a major collapse of the market (if then) to get further reforms.

 

[Hermit]

Unfortunately, I think the number of companies leaving the ACA indicates the government has not figured out how to pay for it yet or make it work profitably for private companies. It will be hard to do with continually escalating medical costs.

 

[travelover]

....... It will be hard to do with continually escalating medical costs.

Yes, the elephant in the room. Costs cannot continue to rise at this rate forever.

 

[MBSC]

Unfortunately, I think the number of companies leaving the ACA indicates the government has not figured out how to pay for it yet or make it work profitably for private companies.

The actuaries employed by the insurance companies set the premiums which drives profit/loss. I agree it could be marketed better.

In the small universe that is health insurance, 2017 may turn out to be pretty nice for the men and women who predict how much insurers have to pay out in claims.

After three years actuaries finally have the information to more accurately forecast what they need to make a profit.

Reference: Health insurance spikes in 2017 may mean more competition

 

[MichaelB]

Unfortunately, I think the number of companies leaving the ACA indicates the government has not figured out how to pay for it yet or make it work profitably for private companies. It will be hard to do with continually escalating medical costs.

So far, only one large / national insurer has announced it will no longer offer individual policies, which is UHC and the subject of this thread. The only other major announcement was some of the BCBS state operations announcing a year ago they would no longer offer PPO plans in Texas and a few other markets. BCBS across the country continues to be the largest insurer in the individual marketplace.

The other large insurers - Aetna, Cigna, Humana, have announced they continue with their expansion plans.

 

[Hamlet]

So Medicare plans are following the ACA plans and severely shrinking their networks of doctors, clinics, labs, and hospitals? I know my employer-provided insurance has been deteriorating and shrinking since 2007, before Obama and ACA came along.

To my understanding, this is the fundamental mistake UHC made with their plans. The exchange customers are extremely price sensitive, for the most part. Most healthy consumers aren't focusing on the network. They are focusing on the price.

The people who are focusing on the networks are the people who have existing relationships with providers that they need to maintain (read - sick people). So an insurer who builds a wide network that includes all of the region's expensive specialty doctors is setting themselves up for adverse selection.

The insurers that are building the cheapest, narrowest network allowed by the ACA are the ones that are going to do well financially. UHC built a wide network and got a disproportionate number of sick people signing up for their plans.

I'm confused about how such a big player could make such a simple misstep, but there you go.

 

[Hermit]

So far, only one large / national insurer has announced it will no longer offer individual policies, which is UHC and the subject of this thread. The only other major announcement was some of the BCBS state operations announcing a year ago they would no longer offer PPO plans in Texas and a few other markets. BCBS across the country continues to be the largest insurer in the individual marketplace.

The other large insurers - Aetna, Cigna, Humana, have announced they continue with their expansion plans.

There is another active thread listing states where Humana is leaving?

 

[Focus]

There is another active thread listing states where Humana is leaving?

Here's the thread (it involves a couple of states): http://www.early-retirement.org/for...-pullout-of-some-markets-next-year-81803.html