Category Archives: Health Insurance

Obamacare premiums in Florida to rise 45 percent on average in 2018, What about deductibles?, Impact on private and company plans?

Obamacare premiums in Florida to rise 45 percent on average in 2018, What about deductibles?, Impact on private and company plans?

Other firms will shift toward part-time workers. More than 40 percent of CFOs say their companies will consider switching some jobs to less than 30 hours per week or targeting part-time workers for future employment.”…Duke University Fuqua School of Business December 11, 2013

“If you like your plan, you can keep it.”…Barack Obama

“millions of Americans are getting or are about to get cancellation letters for their health insurance under Obamacare, say experts, and the Obama administration has known that for at least three years.”…NBC News October 29, 2013

 

We all know that healthcare premiums have skyrocketed since the advent of Obamacare.

Higher deductibles, under reported, are the dinosaur in the room.

And what about private and company plans?

From the Miami Herald September 26, 2017.

“Obamacare premiums in Florida to rise 45 percent on average next year

Health insurers selling Affordable Care Act plans in Florida will raise monthly premiums by nearly 45 percent on average next year, the state’s Office of Insurance Regulation said Tuesday.”

“Florida insurance regulators announced proposed rates for ACA plans in 2018 on Tuesday. Below is a list of insurers and the average rate increase approved by the Office of Insurance Regulation.

On Exchange

  • Blue Cross & Blue Shield of Florida Inc., 38.1 percent
  • Celtic Insurance Company, 46.1 percent
  • Florida Health Care Plans, Inc., 26.5 percent
  • Health First Commercial Plans, Inc., 39.3 percent
  • Health Options, Inc., 36 percent
  • Molina Healthcare of Florida, 71.2 percent

Off Exchange

  • Avmed, Inc., 38.7 percent
  • Cigna Health and Life Insurance Company, 68.9 percent
  • Freedom Life Insurance Company of America, 80 percent”

Read more:

http://www.miamiherald.com/news/health-care/article175550671.html

 

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https://citizenwells.com/

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Deny & Delay tactics of disability insurance companies, Avoid paying legitimate insurance claims, No incentives to pay claims quickly, Many people who have been denied will not pursue, Good Morning America gets answers

Deny & Delay tactics of disability insurance companies, Avoid paying legitimate insurance claims, No incentives to pay claims quickly, Many people who have been denied will not pursue, Good Morning America gets answers

“A San Diego woman says she has been kicked off her insurance plan due to Obamacare while battling Stage 4 gallbladder cancer.

“I had great cancer doctors and health insurance,” Edie Littlefield Sundby wrote in a Sunday Wall Street Journal op-ed. “My plan was canceled. Now I worry how long I’ll live.”

“For almost seven years I have fought and survived Stage 4 gallbladder cancer, with a five-year survival rate of less than 2 percent after diagnosis,” she said.

Her op-ed, which received significant attention from conservatives online, comes as millions of Americans are being dropped from their health insurance plans because of the Patient Protection and Affordable Care Act, President Barack Obama’s signature health care law.

Sundby will be released from her current plan effective Dec. 31. She said her only options going forward are to either enroll in Obamacare and lose her cancer doctors, or to start her treatment all over again with a new provider at rates that are approximately 40 to 50 percent more expensive.

Worse than just losing her doctors through Obamacare, Sundby said, is that nothing available through the government-run program comes even close to comparing with what she had through her private insurer.”…The Blaze November 4, 2013

“Insurance Companies Practice Deny & Delay Tactics”…The Deutermann Law Group

I started Citizen Wells early in 2008 to write about injustice, things that bothered me.

I had no idea then it would evolve into more of a “political animal” and cover in depth Barack Obama and Hillary Clinton as well as a host of others.

I did so out of necessity, love of country, a real concern about what could happen and for my grandkids and descendants.

Little did I know then that a great injustice would happen to me a year later that would drastically affect my life and fortunes.

I had all of the insurance in place.

Health
Life
Dental
Disability

I paid on the private disability policy for 25 years hoping, believing that I would never need to rely on it.

That’s the way it works, right?

No one following this site is aware of what happened to me. For several reasons.

What was happening to this country at the time was more important and because my case was ongoing. It still is.

Over time I will explain my ordeal and how it transpired to the extent I will be legally able to.

But first some background on disability and other insurance companies and how they are treating people.

Anyone watching daytime local tv will notice the high volume of attorney ads offering representation to people who have been wronged by companies, insurance firms and Social Security Disability.

There is obviously a problem.

From the Deuterman Law Group.

“Good Morning America has a story that illustrates how insurance companies use deny and delay tactics to avoid paying legitimate insurance claims.

In this case, a woman with Stage 4 breast cancer tried to collect disability insurance. But Cigna repeatedly denied Susan Kristoff’s claim for short-term disability.

Cigna said she had not proven a disability. Sick and with bills piled up, Kristoff says she considered something drastic.

“If I wasn’t going to be getting better, I didn’t want to sink the rest of my family, so I spent two days in bed crying and thinking about suicide,” she said.

Instead Kristoff hired an attorney. In short order, Cigna reversed course and paid her short-term benefits. Then with her lawyer’s help, she applied for the much more important long-term help.

Several people that GMA interviewed for the story about Kristoff said insurance companies have no incentives to pay claims quickly. In fact, it’s in their best interest to deny and delay claims because many people who have been denied will not pursue things.”

http://deutermanlaw.com/insurance_companies_practice_deny_delay_tactics/

From ABC Good Morning America.

“GMA Gets Answers: Insurer Delays Long-Term Benefit Coverage”

“Kristoff was working at Yellow Book selling advertising 1½ years ago. The job entailed lugging the heavy books to meetings with potential clients. It was a job she loved, until one day a visit to the doctor brought terrible news.

She was diagnosed with stage 4 metastatic breast cancer, and it was spreading throughout her body.

“It was awful, and I was extremely tired — limping, sharp pain,” Kristoff said.

Doctors said there was no way she could do her sales job anymore. The cancer had actually eaten holes through her hips. Her company had no other position to offer her, so Kristoff filed a claim for disability insurance.

Like millions of Americans, she paid a small amount each month — $20 in her case — to cover her financially should she be unable to work. One-third of Americans have some form of disability insurance.

For Kristoff, paying Cigna for disability insurance was the easy part. Collecting the insurance was a different story.

“It was a daily, eight-hour job just trying to fulfill the information that Cigna was requesting,” she said. “And it wasn’t once. It would be over and over again.”

But after five months of submitting forms, Cigna denied Kristoff’s claim for short-term disability. Cigna said she had not proven a disability. Sick and with bills piled up, Kristoff says she considered something drastic.

“If I wasn’t going to be getting better, I didn’t want to sink the rest of my family, so I spent two days in bed crying and thinking about suicide,” she said.

Instead Kristoff hired an attorney. In short order, Cigna reversed course and paid her short-term benefits. Then with her lawyer’s help, she applied for the much more important long-term help.

Delay Tactics

Her policy promised to pay her 60 percent of her salary if she was too disabled to work.

This time Cigna raised a different objection, saying because Kristoff had a different form of cancer two years before she was diagnosed with the breast cancer that had metastasized, she did not qualify for disability. Doctors say the two cancers are unrelated, and she had been diagnosed as cancer-free well before she began her new job.

“I’m appalled, I’m disgusted, but I’m not surprised because there are hundreds of Susans, many of which I’m representing currently,” said Kristoff’s attorney, Alicia Paulino Grisham.

Grisham says she’s seen this tactic before and it’s called “slow walking.”

“The insurance companies understand that if they deny and deny claims, then many of the claimants will never pursue their claim,” Grisham said.”

“”Delay tactics are a killer in this situation — it’s, ‘How do I pay for gas? How do I pay for food? Where’s my day-to-day money? I’m caught up for weeks, months, over a year,'” Cuomo said.

Pisano replied, “I think that it’s a balance. The people who framed this law tried to strike a balance, giving every opportunity to make the case, for there to be a fair and thorough review.”

Finally, Some Good News

“GMA” got involved in Kristoff’s case as she was awaiting the results of yet another appeal.

It had been 1½ years since her cancer diagnosis, but shortly after “GMA” called Cigna on her behalf, Kristoff got some good news.

Cigna announced that based on “additional information … her disability benefits would be covered ” after all.”

Read more:

http://abcnews.go.com/GMA/story?id=4724106&page=1

You will be shocked when you find out what happened to me.

I am one of the lucky ones. I had assets and support but it still destroyed my finances and I am still in pain.

More to come.

Wells

 

More here:

https://citizenwells.com/

http://citizenwells.net/

 

Sean Hannity speaks out on Republican healthcare proposal, “I’m really annoyed about it”, “We don’t want it rammed through.”, Mr. Trump listen to Hannity

Sean Hannity speaks out on Republican healthcare proposal, “I’m really annoyed about it”, “We don’t want it rammed through.”, Mr. Trump listen to Hannity

“You know, I just would have hoped that after eight years of Republicans running on this that they’d have their darn act together, and they’d get a bill that they all agreed on that would fix the problem using all the principles of conservatism.”…Sean Hannity

“millions of Americans are getting or are about to get cancellation letters for their health insurance under Obamacare, say experts, and the Obama administration has known that for at least three years.”…NBC News October 29, 2013

“Healthcare should be affordable and provide a safety net for all citizens. The rest is all fluff.”…Citizen Wells

 

I do not get to listen to Sean Hannity as much as I would like but I do respect his opinion.

I caught a few minutes of his radio show yesterday as he was voicing his concerns about the way the Republicans were rolling out their healthcare proposal.

From CNS News March 9, 2017.

“Hannity ‘Really Annoyed’ About GOP Health Care Bill Rollout: ‘We Don’t Want It Rammed Through’”

“I want to start with this health care debate and the frustration that I feel, and that I have, and why I believe this rollout was not handled properly.

“And look, at the end of the day, do I think it’s all going to probably work out? Are we going to get a repeal and replace? Are we going to get a better health care system? Are we going to undo the mess of Obamacare? None of the promises kept: keep your doctor; keep your plans; save $2,500 a year.

“Yeah, I do believe that we’re going to get there. But in the lead up to all of this – this is one of the most important pieces of legislation.

“And here’s what I don’t understand – and I’ll say this respectfully, but I’m really annoyed about it. Respectfully, the fact that eight years later, that this has been their rallying cry to win the 2010 – win control of the House in 2010 – and then moving further and getting control of the Senate in 2014. And getting the presidency in 2016. And that there’s not a consensus bill. And that—

“I guess in my world, the world that I live in and the way I run my life, knowing – and we had put all these people on beforehand that never saw the bill but were hearing about the bill, and their concerns about the bill. In other words, does it really fully repeal Obamacare? Well, that’s one of the arguments that was used all day yesterday. Or that it has a new entitlement, which is subsidies or – it’s not block granted but, but – tax credits that are given to people so they can afford to buy their own health insurance.

“Now, health care savings accounts are included, money’s not going to Planned Parenthood. This— all the things that I said yesterday, that are good about the bill, that everybody agrees on.

“But here’s my problem: Now here, just imagine, in my own twisted mind, I actually think that Washington can work this way. Maybe all of the people in the Freedom Caucus, the study group, the people now that are angry, these conservative groups like Club for Growth and Americans for Prosperity and Freedom Works and Heritage Foundation and the Heritage Action group, and then you have Senator Rand Paul and Ted Cruz and Mike Lee, and then you have Congressman Louie Gohmert and Congressman Mark Meadows and Dave Brat and Jim Jordan and so many others – they were all saying what they were going to disagree with before the bill ever got released.

“And I remember, and I won’t tell everybody who I talked to, but I told a lot of people, I said, ‘You need to get everybody in a room.’

“And wouldn’t it have been better – instead of having a public fight among Republicans over the repealing and replacing of this bill – if they had gotten together, worked out their differences and maybe the way it was rolled out would be a big monumental ceremony with every Republican in the House and every Republican in the Senate. The president gives a speech. He outlines what’s in the consensus bill of Republicans, how they are going to do it and how it’s going to benefit you, the American people.

“Instead, it, the bill was marked up. Nobody knew what was in it, and when they found out what was in it, it was the very things they were suspicious were going to be in it.”

http://www.cnsnews.com/blog/michael-morris/hannity-really-annoyed-about-gop-health-care-bill-rollout-we-dont-want-it-rammed

 

 

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https://citizenwells.com/

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President Trump executive order to ease burden of Obamacare day 1, January 20, 2017, Essentially allowing the dismantling to begin before Congress moves to repeal it, Minimize the unwarranted economic and regulatory burdens of the act

President Trump executive order to ease burden of Obamacare day 1, January 20, 2017, Essentially allowing the dismantling to begin before Congress moves to repeal it, Minimize the unwarranted economic and regulatory burdens of the act

“Nearly half of U.S. companies are reluctant to hire full-time employees because of the ACA. One in five firms indicates they are likely to hire fewer employees, and another one in 10 may lay off current employees in response to the law.

Other firms will shift toward part-time workers. More than 40 percent of CFOs say their companies will consider switching some jobs to less than 30 hours per week or targeting part-time workers for future employment.”…Duke University Fuqua School of Business December 11, 2013

“If you like your plan, you can keep it.”…Barack Obama

“millions of Americans are getting or are about to get cancellation letters for their health insurance under Obamacare, say experts, and the Obama administration has known that for at least three years.”…NBC News October 29, 2013

 

 

 

From the NY Times January 20, 2017.

“Trump Issues Executive Order Scaling Back Parts of Obamacare

In his first executive order, President Trump on Friday directed government agencies to scale back as many aspects of the Affordable Care Act as possible, moving within hours of being sworn in to fulfill his pledge to eviscerate Barack Obama’s signature health care law.

The one-page order, which Mr. Trump signed in a hastily arranged Oval Office ceremony shortly before departing for the inaugural balls, gave no specifics about which aspects of the law it was targeting. But its broad language gave federal agencies wide latitude to change, delay or waive provisions of the law that they deemed overly costly for insurers, drug makers, doctors, patients or states, suggesting that it could have wide-ranging impact, and essentially allowing the dismantling of the law to begin even before Congress moves to repeal it.

The order states what Mr. Trump made clear during his campaign: that it is his administration’s policy to seek the “prompt repeal” of the law, which has come to be known as Obamacare. But he and Republicans on Capitol Hill have not yet devised a replacement, making such action unlikely in the immediate term.

“In the meantime,” the order said, “pending such repeal, it is imperative for the executive branch to ensure that the law is being efficiently implemented, take all actions consistent with law to minimize the unwarranted economic and regulatory burdens of the act, and prepare to afford the states more flexibility and control to create a more free and open health care market.”

The order has symbolic as well as substantive significance, allowing Mr. Trump to claim he acted immediately to do away with a health care law he has repeatedly called disastrous, even while it remains in place and he navigates the politically perilous process of repealing and replacing it.

Using the phrase “to the maximum extent permitted by law,” the order directs federal agencies to move decisively to implement changes, including granting flexibility that insurers and states had long implored the Obama administration to provide.

It also instructs them to work to create a system that allows the sale of health insurance across state lines, which Republicans have long proposed as the centerpiece of an alternative to the law.

“This action demonstrates that President Trump is committed to fixing the damage caused by Obamacare as soon as possible,” said Senator John Barrasso, Republican of Wyoming.

The order does not direct the Department of Health and Human Services to ease any particular aspect of the 2010 law, but it could result in a substantial weakening of one of its central features: the so-called “individual mandate” that requires most Americans to have health insurance or pay a tax penalty.”

Read more:

Mr. Trump, please send a directive to the IRS to begin dismantling their staff and procedures for taxing Americans due to Obamacare.

God bless.

 

 

More here:

https://citizenwells.com/

http://citizenwells.net/

NC obamacare rates skyrocket, Aetna slashes ACA exchange participation, Blue Cross Blue Shield raises premiums 34 percent lost more than $400 million, Aetna second quarter pre tax loss of $200 million

NC obamacare rates skyrocket, Aetna slashes ACA exchange participation, Blue Cross Blue Shield raises premiums 34 percent lost more than $400 million, Aetna second quarter pre tax loss of $200 million

“If you like your plan, you can keep it.”…Barack Obama

“millions of Americans are getting or are about to get cancellation letters for their health insurance under Obamacare, say experts, and the Obama administration has known that for at least three years.”…NBC News October 29, 2013

“We are being lied to on a scale unimaginable by George Orwell.”…Citizen Wells

 

Are you in NC and seriously considering voting for Hillary the lying sociopath?

Obama’s impact on NC has been catastrophic.

There is no reason to believe that Hillary’s will be less.

From Insurance Journal August 13, 2016.

“Blue Cross Seeks 34% Rate Hike in North Carolina for ACA Plans”

“North Carolina’s largest health insurer says higher-than-anticipated costs after two years of selling federally subsidized coverage has forced it to seek premium increases even greater than it thought would be necessary two months ago.

Blue Cross and Blue Shield of North Carolina said Aug. 6 that it now seeks an average 34.6 percent higher premium for insurance sold under President Barack Obama’s health insurance overhaul law. The company said in June that it wanted to raise rates by an average of almost 26 percent starting in January, compared with this year’s allowed 13.5 percent increase.

The move comes as dozens of health insurers across the country have proposed increasing premiums for individual policies well beyond 10 percent for 2016. However, many of those insurers face pushback from state and federal regulators, and experts say it’s still too soon to say how things will turn out.

Blue Cross vice president Patrick Getzen says the program has not met expectations that healthier customers would enroll in the second year and that costs would level out after people who avoided doctors for years got treatment.

“Based on our data, neither expectation is proving true. Our claims and expenses are higher than our premiums and we need to take steps now to protect the sustainability of plans for our customer over the long-term,” Getzen said.”

Read more:

http://www.insurancejournal.com/news/southeast/2015/08/13/378488.htm

From WRAL August 16, 2016.

“Insurer Aetna slashes ACA exchange participation, exits NC”

“Aetna has become the latest health insurer to retreat from the Affordable Care Act’s public exchanges by announcing a pullback that will further deplete customer choices in many pockets of the country.

The nation’s third largest insurer says it plans to leave nearly 70 percent of the counties in which it currently sells coverage as it trims exchange participation to four states in 2017, down from 15 this year. The move includes ending all Coventry Health Care of the Carolinas plans offered in North Carolina through HealthCare.gov.2

The insurer’s late Monday announcement comes after UnitedHealth and Humana detailed their own exchange pullbacks for 2017 and after more than a dozen nonprofit insurance co-ops have shut down in the past couple years.

Dwindling exchange participation from insurers is becoming a concern because competition is supposed to help control insurance price increases, and many carriers have already announced plans to seek price hikes of around 10 percent or more for 2017. Some states like Alaska and Oklahoma will be left with only one participant selling individual coverage in 2017.”

“The nation’s largest insurer, UnitedHealth Group Inc., had expanded rapidly into the public exchanges and sold coverage in 34 states this year, including North Carolina. But it only plans to offer policies in three states next year, Nevada, Virginia and New York.

The moves by Aetna and UnitedHealth leave Blue Cross Blue Shield of North Carolina as the only insurer to offer Affordable Care Act plans in North Carolina through the HealthCare.gov marketplace, although Cigna Corp. has said it would offer exchange plans in the Raleigh market in 2017.

Blue Cross has lost more than $400 million on exchange plans in the last two years and has considered dropping out as well, but company officials said in May they likely would continue offering exchange plans in 2017, depending on whether state regulators approve requested price increases.

Aetna has said it has been swamped with higher than expected costs, particularly from pricey specialty drugs. The nation’s third-largest insurer said a second-quarter pre-tax loss of $200 million from its individual insurance coverage helped it decide to limit exposure to the exchanges.”

Read more:

http://www.wral.com/insurer-aetna-slashes-aca-exchange-participation-to-4-states/15933839/

 

More here;

https://citizenwells.com/

 

 

Average 2017 Obamacare premium 24 percent increase, Insurance companies exit more states, Aetna to exit 11 of 15 more than two thirds of Obamacare state exchanges, Hillary lies will hurt you too

Average 2017 Obamacare premium 24 percent increase, Insurance companies exit more states, Aetna to exit 11 of 15 more than two thirds of Obamacare state exchanges, Hillary lies will hurt you too

“Nearly half of U.S. companies are reluctant to hire full-time employees because of the ACA. One in five firms indicates they are likely to hire fewer employees, and another one in 10 may lay off current employees in response to the law.

Other firms will shift toward part-time workers. More than 40 percent of CFOs say their companies will consider switching some jobs to less than 30 hours per week or targeting part-time workers for future employment.”…Duke University Fuqua School of Business December 11, 2013

“If you’ve got health insurance we’re going to work with you to lower your premiums by $2,500 per family per year. We will not wait 20 years from now to do it, or 10 years from now to do it. We will do it by the end of my first term as president.”…Barack Obama

“We are being lied to on a scale unimaginable by George Orwell.”…Citizen Wells

 

 

Obama lied about Obamacare and it is a disaster.

Hillary’s lies will hurt you too.

From Zero Hedge August 15, 2016.

“Obamacare Sticker Shock: Average 2017 Premium Surges 24%”

“The reference, of course, was to the state by state surge in proposed 2017 Obamacare premiums, contrasted with what the government contends is a modest 1.0% inflation rate.

Now, courtesy of a new study by independent analyst Charles Gaba – who has crunched the numbers for insurers participating in the ACA exchanges in all 50 states – we can also calculate what the average Obamacare premium increase across the entire US will be: using proposed and approved rate increase requests, the average Obamacare premium is expected to surge by a whopping 24% this year.

As Politico notes, Cigna and Humana recently revised their rate requests in Tennessee, and the new filings are dramatically higher. Cigna is now asking for a 46% average increase, up from 23%, and Humana is requesting a 44% increase, up from 29%, The Tennessean reported on Friday. Expect these numbers to rise even more as insurance companies exit even more states.

So far, the average approved rate increase is roughly 17% according to weighted averages across just five states, Mississippi, New York, Oregon, Rhode Island and Vermont, Gaba reports. “Combined, all [five states] only make up around 6.3 percent of the total population,” Gaba writes. “The numbers will no doubt jump around quite a bit as additional, larger states are plugged into the mix.”

Here is what Charles Gaba calculated:

[I] noted that since I originally crunched the numbers for some states as far back as April, the situation in some states has likely changed somewhat due to carriers dropping out, joining in or re-submitting their rate request filings.

 

There have been significant changes to the requested rate filings in at least four states: Arizona, Connecticut, Maryland and Tennessee. In all four cases, I’m afraid the statewide weighted average has increased, either due to resubmitted filings, a carrier dropping out or both.

 

As a result of these updates, the national average increase requested now stands at 23.9%, up from the previous average of 23.3%.”

Read more:

http://www.zerohedge.com/news/2016-08-15/obamacare-sticker-shock-average-2017-premium-surges-24

 

More here:

https://citizenwells.com/

UnitedHealth Group pulling out of Obamacare exchanges?, Expects major losses on its business through Affordable Care Act, Other insurers sounding alarms about their exchange business, Many insurers have raised premiums to cover medical costs of enrollees

UnitedHealth Group pulling out of Obamacare exchanges?, Expects major losses on its business through Affordable Care Act, Other insurers sounding alarms about their exchange business, Many insurers have raised premiums to cover medical costs of enrollees

“If you’ve got health insurance we’re going to work with you to lower your premiums by $2,500 per family per year. We will not wait 20 years from now to do it, or 10 years from now to do it. We will do it by the end of my first term as president.”…Barack Obama

“Dean Griffin liked the health insurance he purchased for himself and his wife three years ago and thought he’d be able to keep the plan even after the federal Affordable Care Act took effect.

But the 64-year-old recently received a letter notifying him the plan was being cancelled because it didn’t cover certain benefits required under the law.

The Griffins, who live near Philadelphia, pay $770 monthly for their soon-to-be-terminated health care plan with a $2,500 deductible. The cheapest plan they found on their state insurance exchange was a so-called bronze plan charging a $1,275 monthly premium with deductibles totalling $12,700. It covers only providers in Pennsylvania, so the couple, who live near Delaware, won’t be able to see doctors they’ve used for more than a decade.”…Times Colonist November 2, 2013

“We are being lied to on a scale unimaginable by George Orwell.”…Citizen Wells

 

 

 

From Market Watch November 19, 2015.

“UnitedHealth Group Inc. said it expects major losses on its business through the Affordable Care Act’s exchanges and will consider withdrawing from them, in the most prominent signal so far of health insurers’ struggles with the health law’s marketplaces.

The disclosure by the biggest U.S. health insurer, which had just last month sounded optimistic notes about the segment’s prospects, will sharply boost worries about the sustainability of the law’s signature marketplaces, amid signs that many insurers’ losses on the business continue to mount.

UnitedHealth Group’s chief executive, Stephen J. Hemsley, said it made the move, which included a downgrade of its earnings projections for 2015, amid reduced growth expectations, the expected shutdowns of the majority of the health law’s nonprofit cooperative insurers, and signs that its own enrollees continue to increase their use of medical services, raising costs.
As a result, UnitedHealth said it is pulling back on marketing its exchange products, as open enrollment is currently under way for plans that will take effect in 2016. And the insurer said it is “evaluating the viability of the insurance exchange product segment and will determine during the first half of 2016 to what extent it can continue to serve the public exchange markets in 2017.” UnitedHealth had previously expanded its exchange offerings to 11 new states for 2016, and said in October it had around 550,000 people enrolled.

UnitedHealth said it was revising its 2015 earnings projection to $6 a share, from a previous range of $6.25 to $6.35. The move reflected “pressure” of $425 million, or 26 cents a share, tied to individual plans sold under the health law, it said. The $425 million includes $275 million related to the “advance recognition” of losses it expects to incur in 2016. UnitedHealth also said it expects its 2016 earnings to be between $7.10 and $7.30 per share in 2016; previously, the company said it thought next year’s earnings would be within the range of analysts’ projections, then around $7.09 to $7.55.

Chris Rigg, an analyst with Susquehanna Financial Group, wrote that it was likely “this is more of an industry issue,” and if the exchanges don’t stabilize, he would expect UnitedHealth to “exit this business line.”

UnitedHealth’s announcement comes as other insurers have been sounding alarms about their exchange business, but the big insurer went considerably farther than its peers in flagging the recent rapid deterioration of its performance and raising concerns about future viability. UnitedHealth also changed its own tone markedly from its Oct. 15 earnings call, when it said it expected “strikingly better” results on the exchanges in 2016, due partly to price increases that it said averaged in the double digits.

The impact of the insurance industry’s struggles is already clear in the products currently on offer in the marketplaces, many of which are aimed at stanching a flood of red ink. For these plans, which will take effect in 2016, many insurers have raised premiums in order to cover the medical costs of enrollees, which have run higher than many companies originally projected, fueling this year’s losses. Insurers have also shifted to offering more limited choices of health-care providers. The majority of the startup cooperative insurers created under the health law are slated to shut down.

Analysts say the danger is that higher rates might discourage enrollment, particularly by the younger, healthier consumers that the marketplaces need to draw in, since they are the ones that are most likely to feel they can go without insurance. That would have the effect of driving premiums even higher in the future, because insurers would need more rate increases to cover the costs of a smaller, sicker pool of enrollees. At its worst, this cycle can feed on itself, creating what the industry calls a “death spiral.””

Read more:

http://www.marketwatch.com/story/unitedhealth-cuts-guidance-citing-obamacare-2015-11-19