TIPPING POINT FOR OBAMACARE?

Sure As Heck Looks Like It.

What we’ve been sensing lately here in the Florida healthcare trenches, is now being amplified in the national press — newspapers, trade publications and leading industry blogs.

First, before talking about today’s headlines, here are a few examples of what we’ve been seeing as the 4th quarter unfolds and as 2016 fast approaches:

  • A client in the off-exchange individual market with family coverage gets hammered with a 47% increase on an off-exchange qualified health plan from a bellwether carrier.
  • Another individual market client with family coverage loses their plan all together as that same bellwether carrier wipes out a complete category of plans forcing them to look at plans that will either cost a lot more and/or force them into a new category of permission based-plans with severely limited access to providers.
  • Other carriers are limiting their individual market offering to a scant few plans that mostly feature very “skinny” networks, high deductibles, and strict rules requiring referral authorizations from gatekeeper PCP’s.
  • In the small group market, many employees who left their employer-based plans for the promise of lower costs and better benefits are starting to stream back to their employer plans; some almost desperately so after receiving their 2016 renewal notices.
  • More than a few small employers who dropped their plans completely in 2014 and 2015 are exploring once again offering group coverage for their employees.

Then these headlines just this morning:

UnitedHealth Lowers Forecast, Blaming Affordable Care Act New York Times

Biggest Insurer Threatens to Abandon Health Law Wall Street Journal

UnitedHealth May Quit Obamacare in Blow to Health LawBloomberg —

UnitedHealth Group Losing Big Money and Threatening to Leave the Obamacare Exchanges–Because the Obamacare Insurance Business Model Does Not Work Health Care Policy and Marketplace Review

Netting it out, consider these snippets from the Bloomberg article:

“UnitedHealth Group Inc. has scaled back marketing efforts for plans sold to individuals this year and may quit the business entirely in 2017. It’s an abrupt shift from October, when the health insurer said it was planning to sell coverage through the Affordable Care Act in 11 more states next year, bringing its total to 34. The company also cut its 2015 earnings forecast.

“If one of the largest and presumably, by reputation and experience, the most sophisticated of the health plans out there can’t make money on the exchanges, then one has to question whether the exchange as an institution is a viable enterprise,” Skolnick said (Sheryl Skolnick, an analyst at Mizuho Securities).

 And these from Health Care Policy and Marketplace Review:

Every health plan I talk to tells me that they don’t expect their Obamacare business to be profitable even in 2016 after their big rate increases. That does not bode well for the rate increases we can expect to be announced in the middle of next year’s elections”.

”And, then there are the insolvencies of 12 of the 23 original Obamacare co-op insurance companies–the canaries in the Obamacare coal mine–with almost all of the rest of the survivors losing lots of money.”

Hmmmm, tipping point? You can judge for yourself.



Facebook Iconfacebook like buttonTwitter Icontwitter follow buttonVisit Our LinkedIN Profile