United Healthcare May Leave Obamacare by 2017

JumpinJack · Nov 19, 2015

UnitedHealth Group in a surprising announcement, said this morning it has revised its profit expectations for the rest of the year due to what it called a “deterioration” of its individual commercial insurance offerings on government-run exchanges under the Affordable Care Act and offered no commitment it would stay in the business beyond next year.

The nation’s largest health insurer said it was “evaluating the viability of the insurance exchange product segment,” pulling back on its marketing efforts for individual exchange products for next year and “will determine during the first half of 2016 to what extent it can continue to serve the public exchange markets in 2017.” The insurer sells individual plans on public exchanges in 24 states and covers more than a half million Americans in these plans.

UnitedHealth had been among the more cautious in offering coverage to individuals on the exchanges, entering only a handful of markets in 2014, the first year such coverage became available. The company expanded for this year and only recently said it would expand its offerings in nearly a dozen more states for 2016. But this morning, it said the business has deteriorated and it expects a reduction in earnings for the fourth quarter of this year of $425 million, or 26 cents per share “driven by 2015 and 2016 exchange product pressure.”

UnitedHealth Group May Leave Obamacare Exchanges By 2017

This is a bummer, and a big deal, since UNH is the most affordable of the viable insurance companies offering Obamacare in my state, offering the lowest deductible HMOs at the best prices (it doesn't offer PPOs). The other main one is BCBS. Neither of them offer PPOs in my state. BCBS withdrew its PPOs from both Texas and Florida, leaving only the subpar HMOs.

Maybe the answer is to limit coverage of provider visits for anything other than a chronic illness like diabetes? Or to allow to charge slightly higher premiums to those who are likely to turn in massive claims? Then, too, Texas has a high obesity rate, which comes with the metabolic syndrome (diabetes, high blood pressure, high cholesterol); is that it? Or are the ins. cos. being greedy? What's the answer?

joG · Nov 19, 2015

JumpinJack said:
UnitedHealth Group May Leave Obamacare Exchanges By 2017

This is a bummer, and a big deal, since UNH is the most affordable of the viable insurance companies offering Obamacare in my state, offering the lowest deductible HMOs at the best prices (it doesn't offer PPOs). The other main one is BCBS. Neither of them offer PPOs in my state. BCBS withdrew its PPOs from both Texas and Florida, leaving only the subpar HMOs.

Maybe the answer is to limit coverage of provider visits for anything other than a chronic illness like diabetes? Or to allow to charge slightly higher premiums to those who are likely to turn in massive claims? Then, too, Texas has a high obesity rate, which comes with the metabolic syndrome (diabetes, high blood pressure, high cholesterol); is that it? Or are the ins. cos. being greedy? What's the answer?

ACA was like so many things BO has done and said Grand at first hearing, but poorly thought through, sloppy in execution and harmful to the country as a whole after a few months.

Beaudreaux · Nov 19, 2015

JumpinJack said:
UnitedHealth Group May Leave Obamacare Exchanges By 2017

This is a bummer, and a big deal, since UNH is the most affordable of the viable insurance companies offering Obamacare in my state, offering the lowest deductible HMOs at the best prices (it doesn't offer PPOs). The other main one is BCBS. Neither of them offer PPOs in my state. BCBS withdrew its PPOs from both Texas and Florida, leaving only the subpar HMOs.

Maybe the answer is to limit coverage of provider visits for anything other than a chronic illness like diabetes? Or to allow to charge slightly higher premiums to those who are likely to turn in massive claims? Then, too, Texas has a high obesity rate, which comes with the metabolic syndrome (diabetes, high blood pressure, high cholesterol); is that it? Or are the ins. cos. being greedy? What's the answer?

They will not be the only ones to do so, based on trends, and statements made by major firms, and IMHO as well.

buck · Nov 19, 2015

I should go search, but I am fairly certain that proponents of this law have claimed that this was a big company and it was just great they were getting ready to enter new markets.

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.

Bleeding money:

“We cannot sustain these losses,” Chief Executive Officer Stephen Hemsley told analysts on a conference call. “We can’t really subsidize a marketplace that doesn’t appear at the moment to be sustaining itself.”
UnitedHealth said it expects as much as $500 million in losses on the Obamacare plans in 2016. The insurer will record $275 million of the costs in the fourth quarter. United also said Thursday it’s booking $350 million in losses tied to the 2015 performance of its ACA plans.

Questions on other companies:

“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.

Vern · Nov 20, 2015

JumpinJack said:
UnitedHealth Group May Leave Obamacare Exchanges By 2017

This is a bummer, and a big deal, since UNH is the most affordable of the viable insurance companies offering Obamacare in my state, offering the lowest deductible HMOs at the best prices (it doesn't offer PPOs). The other main one is BCBS. Neither of them offer PPOs in my state. BCBS withdrew its PPOs from both Texas and Florida, leaving only the subpar HMOs.

Maybe the answer is to limit coverage of provider visits for anything other than a chronic illness like diabetes? Or to allow to charge slightly higher premiums to those who are likely to turn in massive claims? Then, too, Texas has a high obesity rate, which comes with the metabolic syndrome (diabetes, high blood pressure, high cholesterol); is that it? Or are the ins. cos. being greedy? What's the answer?

Maybe the answer is as simple as having republicans stop attacking Obamacare and stop encouraging people to not sign up. Republicans explicit goal in this matter is to cause a “death spiral”. They are literally hoping the costs go up to the point that only sick people sign up. Wouldn’t you consider it hypocritical that a party that pretends to be “fiscally responsible” trying to make something more expensive for the Americans that use it and the federal govt that subsidizes it? I would.

And in your particular case, expanding Medicaid would help lower your costs.

buck · Nov 20, 2015

Vern said:
Maybe the answer is as simple as having republicans stop attacking Obamacare and stop encouraging people to not sign up.

At least you now (apparently) have joined nearly everyone else and acknowledge that it's a pretty big deal (even critical you may say) that Obamacare missed the 20 million signups expected by the CBO by about 10 million. We are making progress (even if we disagree with the cause) from that conversation we had so long ago.

jaeger19 · Nov 20, 2015

buck said:
I should go search, but I am fairly certain that proponents of this law have claimed that this was a big company and it was just great they were getting ready to enter new markets.

Bleeding money:

Questions on other companies:

Please explain buck how united healthcare was in 4 states and was in the exchanges for a while, and decided then in 2015 to expand from 4 states to 23 and now they do a sudden about face?

Are they simply stupid?

Fenton · Nov 20, 2015

Vern said:
Maybe the answer is as simple as having republicans stop attacking Obamacare and stop encouraging people to not sign up. Republicans explicit goal in this matter is to cause a “death spiral”. They are literally hoping the costs go up to the point that only sick people sign up. Wouldn’t you consider it hypocritical that a party that pretends to be “fiscally responsible” trying to make something more expensive for the Americans that use it and the federal govt that subsidizes it? I would.

And in your particular case, expanding Medicaid would help lower your costs.

Lol !! Blaming the GOP for ObamaCare's failure now are we ?

buck · Nov 20, 2015

jaeger19 said:
Please explain buck how united healthcare was in 4 states and was in the exchanges for a while, and decided then in 2015 to expand from 4 states to 23 and now they do a sudden about face?

Are they simply stupid?

Or entering a new market with far less customers than expected and needed to ensure a healthy mix. Unless you really think they wanted to tank the earnings (and dislike making money) and hurt their stock price and run afoul of the SEC - all on purpose.

UnitedHealth Group also announced it is revising down its earnings outlook for 2015 by about $6 per share, reflecting “expected pre-tax earnings pressure of $425 million,” including $275 million from “advance recognition of 2016 losses.” The company said the earnings revision was due to “projected losses on individual exchange-compliant products related to the 2015 and 2016 policy years.”

The health insurer's move comes amid slowing growth in individual sign-ups for commercial ACA health plans, rising premiums, and increased costs for insurers as those who do enroll in the plans tend to run up larger medical bills.

“In recent weeks, growth expectations for individual exchange participation have tempered industrywide, co-operatives have failed, and market data has signaled higher risks and more difficulties while our own claims experience has deteriorated, so we are taking this proactive step,” Stephen J. Hemsley, CEO of UnitedHealth Group, said in the news release. “We continue to be pleased with the growth and overall performance of our company outside of the individual exchange products and look forward to strong, positive and broad based earnings growth across our enterprise in 2016.”

sangha · Nov 20, 2015

JumpinJack said:
UnitedHealth Group May Leave Obamacare Exchanges By 2017

This is a bummer, and a big deal, since UNH is the most affordable of the viable insurance companies offering Obamacare in my state, offering the lowest deductible HMOs at the best prices (it doesn't offer PPOs). The other main one is BCBS. Neither of them offer PPOs in my state. BCBS withdrew its PPOs from both Texas and Florida, leaving only the subpar HMOs.

Maybe the answer is to limit coverage of provider visits for anything other than a chronic illness like diabetes? Or to allow to charge slightly higher premiums to those who are likely to turn in massive claims? Then, too, Texas has a high obesity rate, which comes with the metabolic syndrome (diabetes, high blood pressure, high cholesterol); is that it? Or are the ins. cos. being greedy? What's the answer?

No, it's not a big deal. In a nation of more than 300 million, a company withdrawing plans for 500,000 is a blip

buck · Nov 20, 2015

sangha said:
No, it's not a big deal. In a nation of more than 300 million, a company withdrawing plans for 500,000 is a blip

Well, we were talking of the exchanges, not the entire country or even world, if that is where you want to go next.

500k in an exchange market of only 10 million, is, at least, a blip.

sangha · Nov 20, 2015

buck said:
Well, we were talking of the exchanges, not the entire country or even world, if that is where you want to go next.

500k in an exchange market of only 10 million, is, at least, a blip.

Agreed, it's a blip, not a big deal.

Vern · Nov 20, 2015

Fenton said:
Lol !! Blaming the GOP for ObamaCare's failure now are we ?

first off fenton, Obamacare isn't failing. I'm simply pointing out that once again republicans push policies that hurt average Americans and increase the deficit.

Fenton · Nov 20, 2015

Vern said:
first off fenton, Obamacare isn't failing. I'm simply pointing out that once again republicans push policies that hurt average Americans and increase the deficit.

:lamo

Yup, it's doing so well VERN that the Democrat candidates during the 2014 Midterms couldn't stop talking about it !! Remember ?? Constant bragging about how well it was doing.

Actually, they avoided the Presidents signature legislation like it was the plague VERN. They, for fear of losing their jobs had to pretend it didn't exist.....and they still got creamed...:2razz:

They even threatened to turn my State ( Texas ) Blue VERN. Well how did that work out for them ? We actually ADDED GOP seats VERN. We're REDDER.

And your assertion that Obama-care's failing because the GOP are telling people not to buy Health Insurance ??? Not ONE, not one Democrat candidate blamed ObamaCare's death spiral on the GOP telling people not to buy insurance.

Nope. So that leads me to believe you just made that up.

imagep · Nov 20, 2015

JumpinJack said:
UnitedHealth Group May Leave Obamacare Exchanges By 2017

This is a bummer, and a big deal, since UNH is the most affordable of the viable insurance companies offering Obamacare in my state, offering the lowest deductible HMOs at the best prices (it doesn't offer PPOs). The other main one is BCBS. Neither of them offer PPOs in my state. BCBS withdrew its PPOs from both Texas and Florida, leaving only the subpar HMOs.

Maybe the answer is to limit coverage of provider visits for anything other than a chronic illness like diabetes? Or to allow to charge slightly higher premiums to those who are likely to turn in massive claims? Then, too, Texas has a high obesity rate, which comes with the metabolic syndrome (diabetes, high blood pressure, high cholesterol); is that it? Or are the ins. cos. being greedy? What's the answer?

Sounds to me that the insurance system we have is failing, despite the Obamacare effort to subsidize it and mandate it.

When an industry is subsidized and we are required to purchase their products, and it is still failing, there is something seriously wrong with the entire system. Time to scrap not only Obamacare, but the entire healthcare system, it's broken and has been broken for decades. Obamacare was just a doubling down on the same broken system.

buck · Nov 20, 2015

sangha said:
Agreed, it's a blip, not a big deal.

Of course its a big deal when one of the largest insurers in the country say they may be leaving the exchanges due to losses. :roll:

You may have a slight bias if you truly believe it's not.

joG · Nov 20, 2015

imagep said:
Sounds to me that the insurance system we have is failing, despite the Obamacare effort to subsidize it and mandate it.

When an industry is subsidized and we are required to purchase their products, and it is still failing, there is something seriously wrong with the entire system. Time to scrap not only Obamacare, but the entire healthcare system, it's broken and has been broken for decades. Obamacare was just a doubling down on the same broken system.

The problem is that Americans spend North of 17 percent of gdp on health care. So insurance costs more premium than people will pay.

sangha · Nov 20, 2015

buck said:
Of course its a big deal when one of the largest insurers in the country say they may be leaving the exchanges due to losses.

No it isnt. It's a blip

JumpinJack · Nov 20, 2015

imagep said:
Sounds to me that the insurance system we have is failing, despite the Obamacare effort to subsidize it and mandate it.

When an industry is subsidized and we are required to purchase their products, and it is still failing, there is something seriously wrong with the entire system. Time to scrap not only Obamacare, but the entire healthcare system, it's broken and has been broken for decades. Obamacare was just a doubling down on the same broken system.

Image: This is a big deal, that UNH is considering withdrawing entirely from the exhanges. It was a big deal with Blue Cross pulled all PPOs out of at least two states, leaving only inferior HMOs, stating it had lost millions. But UNH withdrawing entirely is huge. That is saying that something is very wrong at the core of the program.

I am probably going to buy a UNH policy for 2016 (it only has HMOs in my state), since BCBS cancelled the PPO I have through them. It's distressing to realize that I may be facing another cancelled policy at the end of 2016. What a mess.

Another real danger is if UNH pulls out, others may follow suit, of those who haven't already been bought out, merged, or withdrawn partially. UNH is one of the big boys. If UNH can't make it work, ......

imagep · Nov 20, 2015

JumpinJack said:
Image: This is a big deal, that UNH is considering withdrawing entirely from the exhanges. It was a big deal with Blue Cross pulled all PPOs out of at least two states, leaving only inferior HMOs, stating it had lost millions. But UNH withdrawing entirely is huge. That is saying that something is very wrong at the core of the program.

I am probably going to buy a UNH policy for 2016 (it only has HMOs in my state), since BCBS cancelled the PPO I have through them. It's distressing to realize that I may be facing another cancelled policy at the end of 2016. What a mess.

Another real danger is if UNH pulls out, others may follow suit, of those who haven't already been bought out, merged, or withdrawn partially. UNH is one of the big boys. If UNH can't make it work, ......

I'm probably going to be insurance-less another year.

Doesn't particularly matter to me. My doc only charges $60 for a standard visit, and my family is in good health so we have always spent far less than what health insurance costs.

Worst comes to worst, something horrible happens to one of us, the hospital is still going to treat us, and we just pay what we can afford (which will be less than our insurance would have cost if we purchased it). If health issues become an ongoing problem, then the next year we purchase insurance and we can't be turned down.

JumpinJack · Nov 20, 2015

imagep said:
I'm probably going to be insurance-less another year.

Doesn't particularly matter to me. My doc only charges $60 for a standard visit, and my family is in good health so we have always spent far less than what health insurance costs.

Worst comes to worst, something horrible happens to one of us, the hospital is still going to treat us, and we just pay what we can afford (which will be less than our insurance would have cost if we purchased it). If health issues become an ongoing problem, then the next year we purchase insurance and we can't be turned down.

Oh my gosh, Image! What if you get in an accident and have serious injuries? Or get cancer? Cancer treatment can run over $100k a year, I've read. Such bills could bankrupt you.

Are you sure you want to risk that?

But I must say that I thought about doing just that previously. Friends talked me out of it. I'm healthy (knock on wood). But I could get in an accident, and then the cancer thing can hit anyone at any time. Medical bills are exempt from bankruptcy, I think. So they never go away.

imagep · Nov 20, 2015

JumpinJack said:
Oh my gosh, Image! What if you get in an accident and have serious injuries?

As long as the bill is less than $25k or so, I'm still better off without insurance.

Or get cancer? Cancer treatment can run over $100k a year, I've read. Such bills could bankrupt you.

Pay what I can out of pocket, ask for discounts, and hope that I can delay the bulk of the expense until I purchase insurance the next year.

Are you sure you want to risk that?

not really, but the risk is slim, and the cost of insurance is great. Its a trade off.

But I must say that I thought about doing just that previously. Friends talked me out of it. I'm healthy (knock on wood). But I could get in an accident, and then the cancer thing can hit anyone at any time. Medical bills are exempt from bankruptcy, I think. So they never go away.

I'd rather owe the hospital for the rest of my life, than to beat them out of it - lol. I suppose if things didn't work out well, the hospital bills could be paid out of my estate, won't particularly matter to me at that point. I just hate to toss good money down the drain, betting against myself.

It's really a "game theory" type problem. the worst case scenario is death whether or not I have insurance, the next worst case scenario is a ton of medical bills which I pay off over the course of many years with my savings from not spending money on insurance. The best case scenario is that I save $10k per year by not getting ill and not purchasing insurance, and the most likely scenario statistically is this best case scenario. I weigh everything out, and not purchasing insurance seems to be the best decision, even with the risk.

Helix · Nov 20, 2015

JumpinJack said:
UnitedHealth Group May Leave Obamacare Exchanges By 2017

This is a bummer, and a big deal, since UNH is the most affordable of the viable insurance companies offering Obamacare in my state, offering the lowest deductible HMOs at the best prices (it doesn't offer PPOs). The other main one is BCBS. Neither of them offer PPOs in my state. BCBS withdrew its PPOs from both Texas and Florida, leaving only the subpar HMOs.

Maybe the answer is to limit coverage of provider visits for anything other than a chronic illness like diabetes? Or to allow to charge slightly higher premiums to those who are likely to turn in massive claims? Then, too, Texas has a high obesity rate, which comes with the metabolic syndrome (diabetes, high blood pressure, high cholesterol); is that it? Or are the ins. cos. being greedy? What's the answer?

single payer, which is Medicare for all, and let the wealthy have their second tier. they already do.

buck · Nov 20, 2015

sangha said:
No it isnt. It's a blip

Most people realize it is a big deal.

What's one that is so deluded to not believe so? Rather insignificant.

Moot · Nov 20, 2015

Perhaps United Health Group is losing money because they don't have good consumer relations. The main complaints seems to be that most of the doctors on their network list don't exist and the company refuses to pay for anything.

Top 711 Complaints and Reviews about United Health Care

United Healthcare May Leave Obamacare by 2017

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joG

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Preserve Protect Defend

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buck

sangha

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Vern

back from Vegas

Fenton

imagep

Villiage Idiot

buck

joG

sangha

JumpinJack

imagep

Villiage Idiot

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