GRAHAM-CASSIDY REPEAL BILL DEADLINE:

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Aetna

Over the past year or so, Andrew Sprung of Xpostfactoid, Michael Hiltzik of the L.A. Times and I have repeatedly noted that as much as most insurance carriers may be griping about the individual market, their bread and butter is generally in other divisions, including the large group market but especially Managed Medicaid and Medicare Advantage:

The expansion of Medicaid benefits, thanks largely to the Affordable Care Act, helped increase enrollment in private health plans by 3.4 million in the last year,according to a new report from consulting firm PwC.

...PwC said 73% of Medicaid beneficiaries — or 54.7 million of the 75.2 million Americans covered by the health benefit program for the poor – are enrolled in private plans that contract with the Medicaid program.

...But the growth in the last year wasn’t as fast as 2015 when health plans added more than 8 million Medicaid beneficiaries as more states agreed to expand such coverage under the ACA.

Hey, remember back in August 2016 when Aetna, just three months after saying how great things were going for them on the ACA exchanges (to the point that they might even expand into several additional states), did a complete 180º by announcing that they were instead going to leave 11 of the 15 states they had been participating in?

At the time, it seemed awfully suspicious; as I noted on 8/15/16:

Oh. Well, I'm sure that was just a sheer coincidence, right? No doubt Aetna will clear this up with an unequivocal statement to put any speculation to...

From Peter Sullivan of The Hill:

Asked if the DOJ’s actions on the merger had any relation to Monday’s announcement, Aetna spokesman TJ Crawford did not directly say yes or no.

 

(Updated to add Jeffrey Young to the headline/body...I missed his name on the byline originally, apologies to him!)

Ever since Aetna dropped the bombshell 10 days ago that they were abandoning their previously-announced intention of expanding into additional state ACA exchanges next year and instead might even drop out of some of the states they're already participating in, plenty of people have smelled something fishy about the timing of the 180º turn, given that the original expansion announcement came in mid-May, followed by the Dept. of Justice annoucing that they were suing Aetna to prevent them from merging with Humana in July.

These suspicions became even stronger when Aetna made good on their change of heart two days ago, officially dropping out of 11 of the 15 states they're currently offering on-exchange plans in:

I noted this morning that several of the news stories about Aetna's announcement that they're pulling out of the ACA exchange in 11 states next year included this clarification:

In most areas it’s exiting, Aetna will offer individual coverage outside of the program’s exchanges.

At the time, I only mentioned it in terms of making it tricky to calculate how many current Aetna enrollees would be losing their policies and how much it might impact the average rate hikes for the individual market in that state. After all, if there are 10,000 exchange-based Aetna enrollees and 90,000 off-exchange in a given state, it makes a huge difference whether Aetna is dropping both on & off-exchange plans or on-exchange only.

Yesterday, Aetna delivered a bombshell (well, one which they had forecast a week or so ago, but still) when they announced that not only are they not expanding into additional markets (as they were talking about doing just 3 months earlier), they've actually decided to completely drop out of 11 states:

Health insurer Aetna Inc. will stop selling individual Obamacare plans next year in 11 of the 15 states where it had been participating in the program, joining other major insurers who’ve pulled out of the government-run markets in the face of mounting losses.

Here's the full list of states Aetna is pulling up stakes in:

  • Arizona, Florida, Georgia, Illinois, Kentucky, Missouri, North Carolina, Ohio, Pennsylvania, South Carolina and Texas

Here's the 4 states where Aetna will still be selling exchange-based policies:

May 12, 2016:

Health Insurer Aetna Inc on Wednesday said it plans to continue its Obamacare health insurance business next year in the 15 states where it now participates, and may expand to a few additional states.

"We have submitted rates in all 15 states where we are participating and have no plans at this point to withdraw from any of them," said company spokesman Walt Cherniak. But he noted that a final determination would hinge on binding agreements being signed with the states in September.

Aetna sells the individual coverage on exchanges created by the Affordable Care Act, also called Obamacare. By also filing proposed rates in several other states, Aetna said it had preserved its options to participate in them as well next year. It declined to identify the potential new markets.

The 15 states where it currently participates are Arizona, Delaware, Florida, Georgia, Illinois, Iowa, Kentucky, Missouri, Nebraska, North Carolina, Ohio, Pennsylvania, South Carolina, Texas and Virginia.

Less than 3 months ago, in mid-May, Aetna Inc. made splashy headlines by announcing that not only did they plan on sticking with the ACA individual market exchanges in the 15 states they were already participating in, they were even considering expanding participating to several additional states:

Health Insurer Aetna Inc on Wednesday said it plans to continue its Obamacare health insurance business next year in the 15 states where it now participates, and may expand to a few additional states.

"We have submitted rates in all 15 states where we are participating and have no plans at this point to withdraw from any of them," said company spokesman Walt Cherniak. But he noted that a final determination would hinge on binding agreements being signed with the states in September.

Aetna sells the individual coverage on exchanges created by the Affordable Care Act, also called Obamacare. By also filing proposed rates in several other states, Aetna said it had preserved its options to participate in them as well next year. It declined to identify the potential new markets.

Thanks to JJGomez127 for the heads up:

Kansas health insurance marketplace may gain company offerings for 2017

TOPEKA, KS — Ken Selzer, CPA, Kansas Commissioner of Insurance, said today that Kansas health insurance consumers may have additional company options for coverage in the federallyrun marketplace for 2017.

“Health insurance options filed now for the individual market show that competition will likely continue for Kansans’ health insurance policies,” Commissioner Selzer said.

Filings with the Kansas Insurance Department as of May 2 show two additional carriers may participate in the marketplace. Medica, a non-profit, Minnesota-based company, and Coventry Health and Life are companies that have filed for the 2017 open enrollment period.

Medica Insurance Company is set to offer a number of plans, and Coventry is proposing Exclusive Provider Organization (EPO) Network plans. Both companies have filed to offer plans off the federally-facilitated marketplace as well.

Last month there was much handwringing over the news that UnitedHealthcare has decided to take their ball and go home, pulling out of the individual market in more than 2 dozen states. Shortly after that came the news that Humana is also tidying up their books by dropping individual plans in at least 5 states.

However, capitalism abhors a vacuum. In Iowa, even as UnitedHealthcare is leaving, Wellmark Blue Cross Blue Shield is stepping in to fill the gap there...and today brings some welcome news about another major carrier, Aetna:

Health Insurer Aetna Inc on Wednesday said it plans to continue its Obamacare health insurance business next year in the 15 states where it now participates, and may expand to a few additional states.

Last fall, Aetna reported a total of 1.1 million members in the individual market as of the 3rd quarter, including both ON and OFF exchange enrollees. That was broken out as 815,000 exchange-based (74%) and 280,000 off-exchange (26%).

Just moments ago, Bob Herman reported:

$AET finished Q1 with 1.2 million individual members. (Not sure of #ACA exchange vs off exchange breakout.)

— Bob Herman (@MHbherman) April 28, 2016

Herman just reported that the actual number of exchange-based enrollees is 911,000, a drop of 4.1% year over year.

Noteworthy: Aetna's exchange-based indy enrollments have inched up to 76% of their total indy market.

Here's what the Big Boys are looking like so far:

After UnitedHealthcare freaked everyone in the health insurance investor community out (along with enrollees, politicians, healthcare reporters/pundits, etc.) with their Thursday morning announcement that they might drop off the ACA exchanges in 2017, just 2 years after entering the exchanges and just 1 month after painting a rosy picture of the situation, several other major players in the individual market decided to calm everyone the hell down:

U.S. health insurers Aetna Inc and Anthem Inc on Friday sought to reassure investors that their Obamacare businesses had not worsened after UnitedHealth Group Inc warned of mounting losses in that sector.

Aetna and Anthem said their individual insurance businesses, which include the plans created by President Barack Obama's national healthcare reform law, had performed in line with projections through October. Both backed their earnings forecasts for 2015.

Over at LifeHealth Pro, Allison Bell notes the 2nd quarterly earnings reports for 4 major insurance carriers: Aetna, Molina, Cigna and Health Net.

Unfortunately for my purposes, most of the info here relates to dollars (which is understandable for earnings reports, of course), but there was one relevant enrollment number given:

Molina Healthcare

Molina is reporting $39 million in net income for the latest quarter on $3.5 billion in revenue, compared with $7.8 million in net income on $2.3 billion in revenue for the second quarter of 2014.

The company ended the quarter providing or administering medical coverage for 3.4 million people, up from 2.3 million people a year earlier.

Enrollment in the company's PPACA public exchange qualified health plans (QHPs) increased to 261,000 from 18,000.

That's an impressive year over year increase...over 14x as many ACA exchange enrollees for Molina this year than last.