Nov 6, 2015 @ 07:56 AM 29,123 views
Humana Will Yank Obamacare Plans Serving 100,000 Patients
Bruce Japsen
I write about health care and policies from the president's hometown loss of approximately 150,000 members due to termination by (the Centers for Medicare & Medicaid Services) for lack of proper immigration documentation and/or income status,”
Humana HUM -1.13% (HUM) said it will discontinue several products offered on government-run exchanges under the Affordable Care Act, impacting about 100,000 individuals currently covered by the insurer’s plans across the country.
The move, disclosed this morning in the company’s third-quarter earnings report, comes due to higher-than expected medical costs from sick newly insured patients covered under the health law.
“Operating results for the company’s individual commercial medical business continue to be challenged primarily due to the volatility related to the start of the healthcare exchange program created under the Affordable Care Act as well as the morbidity of membership served under this relatively new program,” Humana said in a statement this morning.
The plans Humana will discontinue had “product designs which attracted a higher-utilizing member base than was assumed when the 2015 plan offerings were priced,” the company said but didn’t specify the kind of plans that will be pulled. “The transitory nature of the population served has also contributed to use of emergency room services and non-participating providers above priced-for levels.”
Bruce Broussard, CEO of Humana, from left, Mark Bertolini, chairman of Aetna, and Joseph “Joe” Swedish, chief executive officer of Wellpoint Inc., walk towards the White House in Washington, D.C., U.S., on Oct. 23, 2013. Photographer: Andrew Harrer/Bloomberg
Humana, which this summer agreed to a takeover by rival Aetna AET -3.74% (AET), said it will continue to evaluate its individual offerings on the public exchanges for 2017. Aetna CEO Mark Bertolini has said the larger company will be committed to offering policies under the health law though Aetna is exiting two states for next year. Humana executives said they weren’t having a conference call to discuss earnings due to the pending merger with Aetna.
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In a press release, Humana said individual commercial membership dropped 11 percent to 963,700 as of September 30 compared to 1,085,800 at September 30, 2014. “These declines were primarily driven by the loss of approximately 150,000 members due to termination by (the Centers for Medicare & Medicaid Services) for lack of proper immigration documentation and/or income status,” the company said.
Despite the “discontinuance” of health plans offered in 2016, Humana said “approximately 88 percent of those will have other Humana options from which they can choose in addition to offerings in the open market.”
Inside Obamacare: The Fix For America’s Ailing Health Care System explores the ways the Affordable Care Act will impact your health care.
Across the country, health plans are evaluating their offerings to Americans on the public exchanges for 2016. While Humana is contracting, other players are moving into new states like the effort by UnitedHealth Group UNH -1.75% (UNH) to expand into 11 new states including California.
http://www.forbes.com/sites/brucejapsen/2015/11/06/humana-will-yank-obamacare-plans-serving-100000-patients-in-2016/
