• This is a political forum that is non-biased/non-partisan and treats every person's position on topics equally. This debate forum is not aligned to any political party. In today's politics, many ideas are split between and even within all the political parties. Often we find ourselves agreeing on one platform but some topics break our mold. We are here to discuss them in a civil political debate. If this is your first visit to our political forums, be sure to check out the RULES. Registering for debate politics is necessary before posting. Register today to participate - it's free!
  • Welcome to our archives. No new posts are allowed here.

Aetna Reports Surge in Profit and a Dark Spot on Results

buck

DP Veteran
Joined
May 29, 2009
Messages
13,061
Reaction score
5,128
Location
USA
Gender
Male
Political Leaning
Conservative
Add Aenta to the list of insurers with some serious concerns regarding the exchange business. They did well on other government plans, though.

The company said its overall profit leapt 38% in the final quarter of the year, as a key measure of spending on medical costs fell. The strong quarterly results were fueled largely by its government business, which includes Medicare and Medicaid.

Aetna said it ended 2015 with about a million customers enrolled in individual health plans—roughly three-quarters of those through the ACA exchanges—and doesn’t expect material growth in the first quarter.

Though the segment’s fourth-quarter performance was a bit better than Aetna last projected, the business lost money in 2015, with a negative margin of around 3% to 4% for the year. Aetna said it aims to get its individual-plan business to break-even in 2016, helped by moves that included withdrawing from some states and rate increases

But Aetna Chief Executive Mark T. Bertolini said during a call with analysts that the company has “serious concerns about the sustainability of the public exchanges” and wants to see more regulatory moves to improve the ACA marketplaces for insurers. The company said tweaks made so far by the Obama administration have been promising but not enough to affect Aetna’s financial projections.

In an interview, Chief Financial Officer Shawn M. Guertin said it was too soon to say what Aetna’s presence on the ACA exchanges would look like in 2017, and the company will need to assess the business going forward. “It’s premature to declare victory or defeat,” he said.
 
They will pull out just like united is doing.

they are losing more money than they are making as they realize the stupidity that obamacare was.
they are not going to sink their company.

however once again insurance rates for people are going to go up to cover the costs.
some places saw a 40% increase in their premiums lol.

still waiting on my 2500 dollar premium reduction.
 
Add Aenta to the list of insurers with some serious concerns regarding the exchange business. They did well on other government plans, though.

The market policies will likely continue to fluctuate. Could people in those exchanges be sicker? Maybe. It might also just have been pent up demand for care.

But the mystery here is identifying a segment within an insured body as "unprofitable". Isn't the whole point of insurance to spread risk? Are they next going to expect that they turn a profit on every customer? Total profit margin is all that is interesting to me. If profit margins remain the same, there shouldn't be any complaining - time will tell on that one. Sure the exchange business from the ACA might not be great for the insurance companies. But we also can't pretend that those profit gains from reduced medical costs didn't also have something to do with the ACA.
 
Isn't the whole point of insurance to spread risk? Are they next going to expect that they turn a profit on every customer?

No, I am sure they don't expect to turn a profit on every customer. But, I am sure they do expect to turn a profit on each channel. If they aren't turning a profit on a channel, expect them to leave that channel. It would be the equivalent of a manufacturer selling a product at a loss at Walmart, hoping they can make enough money selling it at a Target to offset those losses.

Total profit margin is all that is interesting to me.

If that's true, then just think how their "total profit margin" will improve if they just leave the exchanges. That would certainly be interesting.
 
Last edited:
No, I am sure they don't expect to turn a profit on every customer. But, I am sure they do expect to turn a profit on each channel. If they aren't turning a profit on a channel, expect them to leave that channel. It would be the equivalent of a manufacturer selling a product at a loss at Walmart, hoping they can make enough money selling it at a Target to offset those losses.



If that's true, then just think how their "total profit margin" will improve if they just leave the exchanges. That would certainly be interesting.


interesting only in a way that makes me wonder is the capitalist system is the best one for distributing health insurance.
 
No, I am sure they don't expect to turn a profit on every customer. But, I am sure they do expect to turn a profit on each channel. If they aren't turning a profit on a channel, expect them to leave that channel. It would be the equivalent of a manufacturer selling a product at a loss at Walmart, hoping they can make enough money selling it at a Target to offset those losses.



If that's true, then just think how their "total profit margin" will improve if they just leave the exchanges. That would certainly be interesting.

Just imagine what it would have been if they had stayed out of the exchanges..

come on buck.. you have to suspend all disbelief if you think people who were going without healthcare and were working are LESS healthy than the general population. that makes absolutely no sense.
 
Just imagine what it would have been if they had stayed out of the exchanges..

We don't have to imagine. They tell us. They would have had larger profits.
 
We don't have to imagine. They tell us. They would have had larger profits.

And that's why they got into it.. right?

Come on...

Maybe you should work in agriculture a little... its another field that's always crying about how poor we are.
 
And that's why they got into it.. right?

Is that the reason?

Aetna now joins Humana and UHC in stating they lost money on the exchanges and they aren't certain if the exchanges can survive. There are, of course, more insurance companies that have stated the same - in fact most insurance companies have lost money on the exchanges. I realize you don't want to believe it, but there we have it.

We can either trust Jaeger spouting off on a message board with no accountability, or the people intimately familiar with their own finances making statements that are subject to scrutiny and legal actions if not accurate.
 
They will pull out just like united is doing.

they are losing more money than they are making as they realize the stupidity that obamacare was.
they are not going to sink their company.

however once again insurance rates for people are going to go up to cover the costs.
some places saw a 40% increase in their premiums lol.

still waiting on my 2500 dollar premium reduction.

Aetna is very expensive.
 
Is that the reason?

Aetna now joins Humana and UHC in stating they lost money on the exchanges and they aren't certain if the exchanges can survive. There are, of course, more insurance companies that have stated the same - in fact most insurance companies have lost money on the exchanges. I realize you don't want to believe it, but there we have it.

We can either trust Jaeger spouting off on a message board with no accountability, or the people intimately familiar with their own finances making statements that are subject to scrutiny and legal actions if not accurate.

Just FYI: I noticed in my area this year, after HMOs and EPOs became almost the only choices (no PPOs except maybe a couple of really expensive options; not sure, since I didn't shop at the price level), that Obamacare was turning into a sort of Medicaid. When I was calling around trying to find a PCP that would take the BCBS plan I had (the provider list was almost useless....totally fake), I found ONE dr who would take it finally. So that's good. But the two "doctors" that BCBS automatically assigned me to were doctors who worked at Medicaid clinics. (Those drs were no longer in town, though, that I could find. Drs who work at low income clinics I suppose move around a lot.)

I am guessing that's how the insurers want to see the exhange plans go. Like a sort of Medicaid plan. Very few providers. Very limited coverage. Very small drug list. Because there are a lot of really sick people on the plans, who aren't paying high premiums commensurate with their high claims, and they're trying to use the insurance a lot, since they didn't have ins. before in a lot of cases. So the insurers want to control the health care doled out, while increasing the premiums, to make a decent profit. They are in business to make money, so I guess you can't blame them.

It is better in some other states, where there are still PPOs being offered.
 
Just FYI: I noticed in my area this year, after HMOs and EPOs became almost the only choices (no PPOs except maybe a couple of really expensive options; not sure, since I didn't shop at the price level), that Obamacare was turning into a sort of Medicaid. When I was calling around trying to find a PCP that would take the BCBS plan I had (the provider list was almost useless....totally fake), I found ONE dr who would take it finally. So that's good. But the two "doctors" that BCBS automatically assigned me to were doctors who worked at Medicaid clinics. (Those drs were no longer in town, though, that I could find. Drs who work at low income clinics I suppose move around a lot.)

I am guessing that's how the insurers want to see the exhange plans go. Like a sort of Medicaid plan. Very few providers. Very limited coverage. Very small drug list. Because there are a lot of really sick people on the plans, who aren't paying high premiums commensurate with their high claims, and they're trying to use the insurance a lot, since they didn't have ins. before in a lot of cases. So the insurers want to control the health care doled out, while increasing the premiums, to make a decent profit. They are in business to make money, so I guess you can't blame them.

It is better in some other states, where there are still PPOs being offered.

I have insurance. If I didn't have it through my work I would pay the fine as I cannot justify what it would cost me otherwise. The doctor I see on general health issues only takes cash, no insurance. If he needs bloodwork or something done they will submit your insurance to the labs for that. I don't bother with other doctors now. he charges me 75$ max at a visit. no extra for prescriptions or tests that can be done there or anything. I think this is the direction more doctors are going.
 
I have insurance. If I didn't have it through my work I would pay the fine as I cannot justify what it would cost me otherwise. The doctor I see on general health issues only takes cash, no insurance. If he needs bloodwork or something done they will submit your insurance to the labs for that. I don't bother with other doctors now. he charges me 75$ max at a visit. no extra for prescriptions or tests that can be done there or anything. I think this is the direction more doctors are going.

If I could find one that would operate that way, I'd consider it. Of course, I don't have chronic or serious medical conditions (I have none, actually). I imagine that people who have serious conditions need more than that....they wouldn't be getting that expensie cancer drug for free for the cost of the $75 exam, that's for sure.
 
Is that the reason?

Aetna now joins Humana and UHC in stating they lost money on the exchanges and they aren't certain if the exchanges can survive. There are, of course, more insurance companies that have stated the same - in fact most insurance companies have lost money on the exchanges. I realize you don't want to believe it, but there we have it.

We can either trust Jaeger spouting off on a message board with no accountability, or the people intimately familiar with their own finances making statements that are subject to scrutiny and legal actions if not accurate.

Right.. the same people who on one hand.. are "intimately familiar with their own finances".. that after being in the exchanges for a year.. decided to double down and EXPAND their presence in the exchanges.

Who despite this "our profits would be bigger".. continue to make great profits and in some cases record profits.

Lets see.. trust Jaeger who makes sense?

Or trust insurance companies.. ?
 
Just FYI: I noticed in my area this year, after HMOs and EPOs became almost the only choices (no PPOs except maybe a couple of really expensive options; not sure, since I didn't shop at the price level), that Obamacare was turning into a sort of Medicaid. When I was calling around trying to find a PCP that would take the BCBS plan I had (the provider list was almost useless....totally fake), I found ONE dr who would take it finally. So that's good. But the two "doctors" that BCBS automatically assigned me to were doctors who worked at Medicaid clinics. (Those drs were no longer in town, though, that I could find. Drs who work at low income clinics I suppose move around a lot.)

I am guessing that's how the insurers want to see the exhange plans go. Like a sort of Medicaid plan. Very few providers. Very limited coverage. Very small drug list. Because there are a lot of really sick people on the plans, who aren't paying high premiums commensurate with their high claims, and they're trying to use the insurance a lot, since they didn't have ins. before in a lot of cases. So the insurers want to control the health care doled out, while increasing the premiums, to make a decent profit. They are in business to make money, so I guess you can't blame them.

It is better in some other states, where there are still PPOs being offered.

the only real problem here is that "they are trying to use the insurance a lot" business.

Seriously.. how can someone who is truly sick.. very sick.. so sick they have high medical bills that cost so much.... then do without healthcare but still be able to work enough to not qualify for Medicaid?

that's what doesn't make sense in "they are sicker than we thought" argument. These people were working enough to be able to not qualify for Medicaid, yet are supposedly so sick they cost a lot. Doesn't jive with reality.
 
Who despite this "our profits would be bigger".. continue to make great profits and in some cases record profits.

Not on the exchanges, they aren't. There are multiple reports and cites stating the same.

UnitedHealth Makes Good on Threat to Pull Out of Obamacare | The Fiscal Times
United Health and Aetna both reported losses last year after the companies badly underestimated the cost of providing health care insurance to many individuals who turned out to be older and sicker than they had anticipated. UnitedHealth generally enrolled consumers with better health than the overall exchange population, according to Hemsley, but it still lost money.

UnitedHealth Quitting Obamacare Markets in Georgia, Arkansas - Bloomberg
Many insurers have found it difficult to turn a profit in the new markets created by the Affordable Care Act, where individuals turned out to be more costly to care for than the companies expected. UnitedHealth and Aetna Inc. both posted losses from the policies last year, as did big Blue Cross and Blue Shield plans in states like North Carolina.
UnitedHealth began warning in November that it might exit Obamacare markets as it racked up losses. In December, the company said it should have stayed out of the individual exchanges longer.

But right... Jaeger knows best. :roll:
 
Not on the exchanges, they aren't. There are multiple reports and cites stating the same.

UnitedHealth Makes Good on Threat to Pull Out of Obamacare | The Fiscal Times


UnitedHealth Quitting Obamacare Markets in Georgia, Arkansas - Bloomberg


But right... Jaeger knows best. :roll:

Actually yes. Jaeger knows best. He knows the insurance business, he understands the healthcare business and he certainly understand cost shifting.

Like I said.. you can choose to suspend all disbelief... of course these profitable insurance companies.. just HAPPENED to be too stupid to realize just how sick.. these people.. that were healthy enough to work enough to not qualify for Medicaid,, AND were getting by without healthcare insurance...
Just how "sick" these people were. Why after being in the exchanges for a year.. or more.. they didn't realize this.. so they doubled down and expanded their presence.

Sorry.. your premise simply flies counter to rational thought.

The most rational premise is that the insurance companies knew exactly what they were doing. that they got into the exchanges to put the government on the hook. and now with the government on the hook.. politicians have three choices. Raise the rates that they can charge.. and have people PISSED at them for having to pay more.
Let the insurance companies ditch the exchanges.. and have people PISSED at them for being kicked off insurance.

OR allow insurance companies to raise rates AND subsidize those rate increases with taxpayer dollars and keep their constituents from firing them. Republican or democrat.

Ding Ding.. the third option makes the most sense. Its simply extortion by the insurance companies.. and they cost shifted every cost imaginable over to the exchange side of the business.. to justify the extortion.

THAT makes sense.
 
Like I said.. you can choose to suspend all disbelief... of course these profitable insurance companies.. just HAPPENED to be too stupid to realize just how sick.. these people..

Obamacare patients sicker and pricier than expected - Mar. 30, 2016

Obamacare patients sicker and pricier than expected

Patients in Obamacare are sicker and need significantly more medical care than those in employer-sponsored plans, according to a new Blue Cross Blue Shield Association report.

The study, the first of its kind to look at millions of enrollees across the country, found that Obamacare members have higher rates of costly illnesses such as diabetes, depression, hypertension, heart disease, HIV and Hepatitis C.

They also use more medical services -- including emergency rooms, in-patient hospital care, doctors and prescriptions than patients in employer-sponsored plans. Their cost of care was 22% higher than those in work-based health plans in 2015, or $559 a month, on average, for Obamacare enrollees versus $457 for those in employer plans.

Still, the fact that these patients are sicker than expected is putting some insurers in a financial bind. Several have reported big losses and have questioned whether they can afford to remain in the Obamacare market. This group includes UnitedHealth (UNH), the nation's largest insurer, which expects to lose nearly $1 billion on Obamacare in 2015 and 2016 and may not participate in 2017.

Oops. :roll:
 
Obamacare patients sicker and pricier than expected - Mar. 30, 2016

Obamacare patients sicker and pricier than expected









Oops. :roll:

Bull.

Lets get this straight.

Able to work enough that they don't qualify for Medicaid.

So sick that they have costly HTN, Depression, heart disease, etc etc.... BUT were able to still work WITHOUT HEALTHCARE

bull. Now if you believe everything that an insurance company says out of hand.. well that makes sense then.

The rest of us with a little more objectivity and understanding of healthcare and people.. we know better.

ooops.
 
Able to work enough that they don't qualify for Medicaid.

So sick that they have costly HTN, Depression, heart disease, etc etc.... BUT were able to still work WITHOUT HEALTHCARE

I can provide unlimited cites from multiple sources stating the same... You seem not to be able to provide one to support your position. Shrug.
 
Back
Top Bottom