Cooperating for better care.

insurance exchanges

Tag Archives

Aetna bailing out of all ACA exchanges


Aetna will complete its withdrawal from Affordable Care Act state insurance exchanges in 2018. The huge insurer, which overall is very profitable, said that continuing financial losses in the exchanges and uncertainty about the marketplaces’ future led it to decide to leave the last  two states  — Delaware and Nebraska — in which it has been on ACA exchanges. Just last week it said that it would stop offering ACA health plans in Virginia in 2018 and last month it  said it would leave Iowa.

Aetna Chief Executive Mark Bertolini has said that the ACA marketplaces were in a “death spiral,” which the nonpartisan Congressional Budget Office said isn’t true.

The exchanges have been undermined by the fierce opposition to the Affordable Care Act of the Trump administration and Republican politicians in Red States.

Insurers, for their part, complain that their ACA plans attract too few of the young and healthy customers needed to offset the expense of covering older people, who, of course, tend to have more serious  health problems than do younger people.

A major reason is that the financial penalties for people for not buying insurance are far too small.

For example, the penalty for not buying insurance for an adult is $625 per adult and $347.50 per child under 18. So a lot of younger healthy people decide to pay the fine, which is much cheaper than paying insurance premiums. And if they get sick or injured, they can go to a hospital ER, where all or some of the costs will be covered by the hospital, in the form of “charity care” and local, state and federal governments.

It’s all just another example of why  the U.S. healthcare system is near the bottom in medical outcomes and at the top in costs in the Developed World. It’s immensely complicated and contradictory, fee-driven and fueled by the desire of many, perhaps most, clinicians and hospital and insurance executives for maximum personal profit.

To read more, please hit this link.


Big insurers’ exits revive talk of Medicare for all


As big insurers bail out of the insurance exchanges created by the Affordable Care Act, the idea of simplifying, and saving money on, the currently chaotic U.S. healthcare “system” by extending Medicare to all, or at least offering a “public option” on the exchanges, is gaining ground.

Polls suggest that a majority of the population would like Medicare for all but  the  insurance companies have a powerful lobbying and campaign-contribution operation in Washington to try to thwart that.

President Obama, pushing back against criticism of the Affordable Care Act in the wake of the insurance company exits from ACA’s insurance exchanges, has revived the idea of introducing a public, Medicare-like plan to compete with private insurers. He also has suggested that increased government subsidies could help draw more people into the ACA’s markets.

Bloomberg has noted also: “Another option is to simply give insurance companies more government money, but that would require action from a Republican Congress that would rather repeal Obamacare than fix it.”

‘There’s going to be absolutely zero interest among Republicans in bailing out Obamacare by giving it more money,”  Avik Roy, a healthcare expert who’s advised Republican presidential candidates Mitt Romney, Rick Perry and Marco Rubio on health policy, told Bloomberg.

With  such unknowns as who will control the White House and one or both houses of Congress after the November election, one would have to be very brave to make predictions.

To read the Bloomberg article on this developing story, please hit this link.

Contact Info

(617) 230-4965

Wellesley, Mass