Saturday, 20 October, 2018

Health insurer Aetna backs off ACA expansion plans

Preston Stone | 06 August, 2016, 00:24

(MOH) for a total estimated $117 million in cash for both transactions, based on the estimated number of members in the plans involved in the transactions.

Aetna requested that its proceeding go forward this fall, before the December 31 deadline for the completion of its $33 billion merger with Humana.

The Pennsylvania Attorney General's Office is part of the lawsuit against the Aetna-Humana deal, which lists Lancaster among 350 counties nationwide where Medicare Advantage enrollees would be particularly impacted.

"We believe that these divestitures taken together would address the Department of Justice's perceived competitive concerns regarding Medicare Advantage", Aetna CEO Mark T. Bertolini and Humana CEO Bruce Broussard said in a joint statement. The U.S. Justice Department already has sued to block the deal on antitrust grounds.

The company's announcement follows its failed merger with Humana, when the Department of Justice blocked the deal, along with Anthem's purchase of Cigna.

Aetna is reconsidering its participation in Obamacare, making it the latest large insurer to cast doubts on the future of the individual exchanges.

Now, its losing money on Obamacare and Aetna said it is setting up a reserve of $65 million to account for expected losses on individual plans for the rest of the year in the exchanges for the affordable care act.

In an unexpected move, health insurer Aetna is halting plans for ObamaCare expansion and is evaluating whether to continue participating in ObamaCare at all.

Aetna joins a growing list of health insurance companies that are struggling to make money from the new law.

Humana reaffirmed its 2016 guidance for adjusted earnings of at least $9.25 a share.

Excluding special items, Aetna earned $2.21 per share, exceeding the analysts' average estimate of $2.12, according to Thomson Reuters I/B/E/S.

Revenue rose 2 percent to $14.01 billion.

Asked about the timing of Aetna's Obamacare re-evaluation, Bertolini said people seeking care through the exchange products need coverage, but the company also has an obligation to its 23 million other customers who need to have a solvent insurer.

Not all insurers are retrenching- Cigna Corp., though it said it expected a loss this year on its exchange business, still plans to expand into a few new markets.

Some 11.1 million people are enrolled in Obamacare this year, according to the latest federal statistics.

Humana Inc. reported better-than-anticipated earnings and a surprise rise in revenue in the most recent quarter as a key measure of the company's medical costs fell. But Aetna says the business lost roughly $200 million in the second quarter and expects a loss of more than $300 million for the full year. Bertolini told analysts Tuesday that a federal risk adjustment program created to assist insurers that take on high-cost patients hasn't help Despite the losses and concerns voiced by insurers, federal regulators remain hopeful about the public exchanges. He said consumers can easily sign up for health coverage when they're sick, and then jump off after health services are paid for.


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