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data-mobilepath="/us/entry/571554d9e4b0018f9cbade3b" data-sharingimage="http://img.huffingtonpost.com/asset/360_216/571555162200003600253d11.jpeg?cache=sbf920sjek" data-sharingtitle="Major Health Insurer Bailing On Most Obamacare Exchanges" data-sharingtweetname="HuffPostPol" data-sharingtweettext="One+big+insurer+is+tired+of+losing+money+on+Obamacare+plans" data-sharingurl="http://www.huffingtonpost.com/entry/unitedhealth-group-obamacare-exchanges_us_571554d9e4b0018f9cbade3b" data-socialmessaging="{}" dir="ltr" id="us_571554d9e4b0018f9cbade3b" path="/us/entry/us_571554d9e4b0018f9cbade3b" type="article"> <div id="left-rail-trending"></div> <div class="entry__container"> <header class="entry__header" data-beacon="{"p":{"mnid":"headline"}}"> <span class="entry-eyebrow"> <a class="entry-eyebrow__link" data-beacon="{"p":{"mpid":"top_section","lnid":"politics","plid":"/section/politics"}}" href="/web/20160818073128/http://www.huffingtonpost.com/section/politics">POLITICS </a></span> <div class="headline"> <h1 class="headline__title">Major Health Insurer Bailing On Most Obamacare Exchanges</h1> <h2 class="headline__subtitle">UnitedHealth Group's decision underscores challenges facing the Affordable Care Act marketplaces.</h2> </div> <div class="timestamp"> <span class="timestamp__date--published">04/19/2016 10:46 am ET</span> </div> <div class="js-horizontal-share share-bar share-bar--horizontal" data-beacon="{"p":{"mnid":"headline_share_bar"}}"> <div class="share-bar__social-counts"> <span class="share-bar__social-counts__number">3.4k</span> </div> <ul class="share-bar__list"> <li class="bN facebook share-bar__item" data-beacon="{"p":{"lnid":"facebook","mpid":1}}" data-type="facebook"> <a class="share-bar__item-link" href="#" target="_blank"></a> </li> <li class="bN share-bar__item twitter" data-beacon="{"p":{"lnid":"twitter","mpid":2}}" data-type="twitter"> <a class="share-bar__item-link" href="#" target="_blank"></a> </li> <li class="bN pinterest share-bar__item" 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class="author-card__details__link" data-beacon="{"p":{"lnid":"author"}}" data-plid="jeffrey-young" href="/web/20160818073128/http://www.huffingtonpost.com/author/jeffrey-young"><span class="author-card__details__name">Jeffrey Young</span> </a><span class="author-card__social-container"> <a class="author-card__social author-card__social--facebook" data-beacon="{"p":{"lnid":"author_facebook"}}" href="https://web.archive.org/web/20160818073128/http://facebook.com/jcydc" target="_blank"></a> <a class="author-card__social author-card__social--twitter" data-beacon="{"p":{"lnid":"author_twitter"}}" href="https://web.archive.org/web/20160818073128/http://twitter.com/JeffYoung" target="_blank"></a> </span> </span> <span class="author-card__microbio"> Senior Reporter, The Huffington Post </span> </div> </div> </div> </div> </header> <div class="entry__content js-entry-content"> <div class="entry__body js-entry-body"> <div class="top-media" data-beacon="{"p":{"mnid":"top_media"}}"> <div class="top-media--image"> <figure class="content-list-component image"> <img class="image__src" src="https://web.archive.org/web/20160818073128im_/http://img.huffingtonpost.com/asset/scalefit_630_noupscale/571555162200003600253d11.jpeg?cache=sbf920sjek"/> <div class="image__credit js-image-credit"> Danny Moloshok/Reuters </div> <figcaption class="image__caption js-image-caption"> UnitedHealth Group CEO Stephen Hemsley. </figcaption> </figure> </div> <script></script> <iframe style="display: none;"></iframe> </div> <div class="share-bar-highlight js-highlight hidden"> <a class="share-bar-highlight__twitter js-highlight-share-button" data-beacon="{"p":{"lnid":"twitter","mnid":"entry_text","plid":"http://www.huffingtonpost.com/entry/unitedhealth-group-obamacare-exchanges_us_571554d9e4b0018f9cbade3b"}}" data-type="twitter"></a> <a class="share-bar-highlight__facebook js-highlight-share-button" data-beacon="{"p":{"lnid":"facebook","mnid":"entry_text","plid":"http://www.huffingtonpost.com/entry/unitedhealth-group-obamacare-exchanges_us_571554d9e4b0018f9cbade3b"}}" data-type="facebook"></a> </div> <div class="content-list-component text"><p><span style="font-weight: 400;">WASHINGTON -- UnitedHealth Group, the largest health insurer in the U.S., will pull out of most states' Obamacare exchanges next year, the company announced Tuesday.</span></p> <p><span style="font-weight: 400;">UnitedHealth cited about $1 billion in losses over the past two years for the firm's decision to significantly scale back its business on the health insurance exchanges created by the Affordable Care Act.</span></p> <p><span style="font-weight: 400;">UnitedHealth offers policies on the exchange marketplaces in 34 states this year, but will only remain in a "handful" of states in 2017, UnitedHealth CEO Stephen Hemsley said during a conference call on the company's quarterly earnings. The company </span><a href="https://web.archive.org/web/20160818073128/http://www.huffingtonpost.com/entry/obamacare-dying-unitedhealth_us_564e25dce4b00b7997f9dd0c"><span style="font-weight: 400;">cautioned in November</span></a><span style="font-weight: 400;"> it might bail on the marketplaces nationwide.</span></p> <p><span style="font-weight: 400;">The UnitedHealth Group announcement and warning signs from other health insurers that Obamacare enrollees are costlier than expected serve as a reminder of how new and how fragile the health insurance exchange marketplaces are ahead of the open enrollment period for 2017 coverage, which begins this fall. </span></p> <p><span style="font-weight: 400;">President Barack Obama's health care overhaul may have extended health coverage to an estimated </span><a href="https://web.archive.org/web/20160818073128/http://www.huffingtonpost.com/entry/health-insurance-obamacare_us_56d8a717e4b0000de403d404"><span style="font-weight: 400;">20 million people </span></a><span style="font-weight: 400;">and brought the uninsured rate to </span><a href="https://web.archive.org/web/20160818073128/http://www.gallup.com/poll/190484/uninsured-rate-lowest-eight-year-trend.aspx"><span style="font-weight: 400;">an all-time low</span></a><span style="font-weight: 400;">, but its future remains uncertain as market dynamics continue to play out. No matter what UnitedHealth Group may be doing next year, it's </span><a href="https://web.archive.org/web/20160818073128/http://www.huffingtonpost.com/entry/obamacare-sign-up-deadline_us_56ac059be4b00b033aaf3eef"><span style="font-weight: 400;">going to take longer than that</span></a><span style="font-weight: 400;"> to determine whether the regulated, subsidized health insurance exchange market will be viable long term.</span></p> <p><span style="font-weight: 400;">At the end of the 2016 sign-up period in February, </span><a href="https://web.archive.org/web/20160818073128/http://www.huffingtonpost.com/entry/12-million-enroll-obamacare_us_56b3a063e4b01d80b2457abf"><span style="font-weight: 400;">close to 13 million people</span></a><span style="font-weight: 400;"> had private health insurance obtained via the exchanges. But enrollment </span><a href="https://web.archive.org/web/20160818073128/http://www.huffingtonpost.com/entry/obamacare-uninsured-rates_us_56b90b93e4b08069c7a872dd"><span style="font-weight: 400;">may have virtually plateaued</span></a><span style="font-weight: 400;">, the Congressional Budget Office </span><a href="https://web.archive.org/web/20160818073128/https://www.cbo.gov/publication/51385"><span style="font-weight: 400;">projects modest growth</span></a><span style="font-weight: 400;"> in future years, and concerns remain that younger, healthier consumers don't consider the coverage to be affordable or a good value.</span></p> <p><span style="font-weight: 400;">"Our own experience and performance have been unfavorable in these markets. The smaller overall market size, the shorter-term, higher-risk profile within this market segment continue to suggest we cannot broadly serve it on an effective and sustained basis. Next year, we will remain in only a handful of states," Hemsley said during the conference call.</span></p></div> <figure class="content-list-component image"> <img class="image__src" src="https://web.archive.org/web/20160818073128im_/http://img.huffingtonpost.com/asset/scalefit_630_noupscale/56df40631500002a000b169f.png"/> <div class="image__credit js-image-credit"> The Huffington Post </div> </figure> <div class="content-list-component text"><p><span style="font-weight: 400;">The administration sought to tamp down worries about the overall state of the health insurance exchanges despite this uncertainty. </span></p> <p><span style="font-weight: 400;">"As with any new market, we expect changes and adjustments in the early years with issuers both entering and exiting states. The marketplace is a reliable source of coverage for millions of Americans with a robust number of plan choices. We have full confidence, based on data, that the marketplaces will continue to thrive for years ahead. The number of issuers per state has grown year-over-year," Department of Health and Human Services spokesman Ben Wakana said in a statement Monday.</span></p> <p><span style="font-weight: 400;">Other insurers, including </span><a href="https://web.archive.org/web/20160818073128/http://www.forbes.com/sites/brucejapsen/2016/02/10/obamacare-losses-for-humana-mean-potential-withdrawal-in-2017/#31505946761d"><span style="font-weight: 400;">Humana</span></a><span style="font-weight: 400;"> and </span><a href="https://web.archive.org/web/20160818073128/http://www.newsobserver.com/news/business/article59636351.html"><span style="font-weight: 400;">Blue Cross Blue Shield of North Carolina</span></a><span style="font-weight: 400;">, also have publicly weighed ending their participation in the exchanges because of losses related to attracting </span><a href="https://web.archive.org/web/20160818073128/http://www.huffingtonpost.com/entry/obamacare-enrollees-are-sick_us_56face7be4b0143a9b497571"><span style="font-weight: 400;">too many sick customers</span></a><span style="font-weight: 400;"> and too few healthy ones.</span></p> <p><span style="font-weight: 400;">But some insurance companies have earned profits on their exchange business, or at least are willing to sustain losses while the market matures, including </span><a href="https://web.archive.org/web/20160818073128/http://khn.org/news/aetna-ceo-answers-burwells-call-vows-support-for-exchanges-amid-losses/"><span style="font-weight: 400;">Aetna</span></a><span style="font-weight: 400;">, </span><a href="https://web.archive.org/web/20160818073128/http://ctmirror.org/2015/11/20/unlike-unitedhealth-aetna-anthem-say-they-will-stay-in-aca-exchanges/"><span style="font-weight: 400;">Anthem</span></a><span style="font-weight: 400;">, </span><a href="https://web.archive.org/web/20160818073128/http://www.modernhealthcare.com/article/20160212/NEWS/160219960"><span style="font-weight: 400;">Kaiser Permanente</span></a><span style="font-weight: 400;">, </span><a href="https://web.archive.org/web/20160818073128/http://www.modernhealthcare.com/article/20160209/NEWS/160209852"><span style="font-weight: 400;">Molina Healthcare</span></a><span style="font-weight: 400;"> and </span><a href="https://web.archive.org/web/20160818073128/http://www.lifehealthpro.com/2016/02/10/centene-likes-its-ppaca-exchange-margins"><span style="font-weight: 400;">Centene</span></a><span style="font-weight: 400;">. Aetna is seeking federal approval to merge with Humana, and Anthem needs the government's OK to proceed with its plan to combine with Cigna, which could make these companies </span><a href="https://web.archive.org/web/20160818073128/http://www.forbes.com/sites/brucejapsen/2016/04/17/insurers-may-leave-obamacare-markets-but-dont-expect-a-mass-exodus/#4dffd41c1088"><span style="font-weight: 400;">more likely to remain</span></a><span style="font-weight: 400;"> in the exchanges to keep favor with the administration. </span></p> <p><span style="font-weight: 400;">UnitedHealth is a relatively minor player in the exchanges. Despite offering plans in more than 30 states this year, the company's</span><a href="https://web.archive.org/web/20160818073128/http://www.modernhealthcare.com/article/20160119/NEWS/301199998"><span style="font-weight: 400;"> approximately 800,000</span></a><span style="font-weight: 400;"> exchange customers represent only a 6 percent national market share. </span></p> <p><span style="font-weight: 400;">UnitedHealth was among the lowest-priced sellers in few markets and failed to attract large numbers of customers in most states, according to </span><a href="https://web.archive.org/web/20160818073128/http://khn.org/news/competition-suffers-most-if-unitedhealth-exits-obamacare-in-2017-analysis/"><span style="font-weight: 400;">an analysis</span></a><span style="font-weight: 400;"> based on its 2016 business that the Henry J. Kaiser Family Foundation published Monday. </span></p> <p><span style="font-weight: 400;">The impact of UnitedHealth's departure from the marketplaces would be modest nationally, but significant in some states, where premiums would rise and consumers would have less choice, according to the Kaiser Family Foundation. Consumers in Alabama, Arizona, Iowa, Nebraska and North Carolina would see the biggest negative effects if UnitedHealth left, </span><a href="https://web.archive.org/web/20160818073128/http://kff.org/health-reform/issue-brief/analysis-of-unitedhealth-groups-premiums-and-participation-in-aca-marketplaces/"><span style="font-weight: 400;">the report</span></a><span style="font-weight: 400;"> concludes.</span></p> <p>Hemsley didn’t say what states UnitedHealth would leave or where they would remain. UnitedHealth previously said it wouldn’t sell policies on the exchanges in <a href="https://web.archive.org/web/20160818073128/http://www.bloomberg.com/news/articles/2016-04-08/unitedhealth-quitting-obamacare-markets-in-georgia-arkansas" target="_blank">Arkansas</a> and <a href="https://web.archive.org/web/20160818073128/http://www.wsj.com/articles/unitedhealth-to-stop-offering-affordable-care-act-plans-in-michigan-in-2017-1460771795" target="_blank">Michigan</a>, and would maintain <a href="https://web.archive.org/web/20160818073128/http://www.bloomberg.com/news/articles/2016-04-18/for-some-states-unitedhealth-exit-from-obamacare-would-hurt" target="_blank">only a small presence in Georgia</a> next year. Bloomberg News reported <span class="aBn" tabindex="0" data-term="goog_656727369"><span class="aQJ">Monday</span></span> the insurer also would leave <a href="https://web.archive.org/web/20160818073128/https://twitter.com/ZTracer/status/722182808979042305" target="_blank">Louisiana</a> and <a href="https://web.archive.org/web/20160818073128/http://www.bloomberg.com/news/articles/2016-04-18/for-some-states-unitedhealth-exit-from-obamacare-would-hurt" target="_blank">Oklahoma</a>.</p></div> <div class="content-list-component embed-asset"><div class="vdb_player vdb_5668ae6ee4b0b5e26955d6a656000e19e4b0e4e194b84b31" vdb_params="m.fwkeyvalues=sponsorship%3D&m.fwsitesection=us.politics"><script type="text/javascript" src="//web.archive.org/web/20160818073128js_/http://delivery.vidible.tv/jsonp/pid=5668ae6ee4b0b5e26955d6a6/vid=570e9ad9e4b0f19da2b91a76/56000e19e4b0e4e194b84b31.js"></script></div></div> <div class="content-list-component text"><p><span style="font-weight: 400;">Three years into the exchange market's existence, insurers have an incentive to pressure the federal and state exchange regulators with threats to exit the markets to gain leverage when their premium increases are reviewed, or to win favorable treatment on other issues, such as a permanent repeal of an Affordable Care Act tax on their products. Likewise, the administration has an incentive to portray its health overhaul in a positive light by downplaying the specific effects of UnitedHealth's withdrawals. </span></p> <p><span style="font-weight: 400;">Those insurers losing money on the exchanges are likely to ask for</span><a href="https://web.archive.org/web/20160818073128/http://www.huffingtonpost.com/entry/obamacare-premiums_us_570d94a8e4b0ffa5937d7963"><span style="font-weight: 400;"> larger rate hikes next year</span></a><span style="font-weight: 400;"> to compensate, requests that already are trickling in to state and federal regulators. </span><a href="https://web.archive.org/web/20160818073128/https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-02-04.html"><span style="font-weight: 400;">About 85 percent</span></a><span style="font-weight: 400;"> of exchange customers receive federal subsidies that can </span><a href="https://web.archive.org/web/20160818073128/http://www.huffingtonpost.com/entry/obamacare-premiums_us_570d94a8e4b0ffa5937d7963"><span style="font-weight: 400;">shield them from premium increases</span></a><span style="font-weight: 400;">, and the 2015 and 2016 enrollment periods demonstrated that exchange customers are </span><a href="https://web.archive.org/web/20160818073128/http://www.huffingtonpost.com/entry/obamacare-premiums_us_570d94a8e4b0ffa5937d7963"><span style="font-weight: 400;">prone to shop around</span></a><span style="font-weight: 400;"> and switch carriers to save money, which could limit the financial impact of higher prices.</span></p> <p><span style="font-weight: 400;">But the remaining 15 percent of exchange enrollees and the estimated 9 million people who buy health insurance off the exchanges directly from the carrier or through a broker aren't subsidized and will </span><a href="https://web.archive.org/web/20160818073128/http://www.huffingtonpost.com/entry/obamacare-premiums_us_570d94a8e4b0ffa5937d7963"><span style="font-weight: 400;">bear the full brunt</span></a><span style="font-weight: 400;"> of whatever premium increases are coming.</span></p> <p><span style="font-weight: 400;">The Obama administration has taken some steps to address insurer concerns, including </span><a href="https://web.archive.org/web/20160818073128/http://healthaffairs.org/blog/2016/01/20/after-insurer-complaints-small-steps-to-toughen-special-enrollment-period-eligibility/"><span style="font-weight: 400;">imposing new requirements</span></a><span style="font-weight: 400;"> consumers must meet to sign up outside the annual enrollment period, and Congress reduced the cost pressures facing insurers by </span><a href="https://web.archive.org/web/20160818073128/http://www.modernhealthcare.com/article/20160301/NEWS/160309994"><span style="font-weight: 400;">blocking an Obamacare tax </span></a><span style="font-weight: 400;">on the companies next year.</span></p> <p><span style="font-weight: 400;">The administration is severely limited in what it can do to address the underlying issues, beyond outperforming itself in enrolling more healthy consumers for next year. The White House has </span><a href="https://web.archive.org/web/20160818073128/http://www.huffingtonpost.com/entry/how-obama-would-fix-obamacare_us_56bcd8d6e4b0c3c550506e19"><span style="font-weight: 400;">proposed policies </span></a><span style="font-weight: 400;">designed to make the Affordable Care Act function more smoothly, but they have been ignored by the Republican-controlled Congress. The GOP, meanwhile, remains focused on repealing the law and replacing it with a </span><a href="https://web.archive.org/web/20160818073128/http://thehill.com/policy/healthcare/276547-gop-group-promises-obamacare-replacement-plan-soon"><span style="font-weight: 400;">still-unknown plan </span></a><span style="font-weight: 400;">of its own.</span></p> <p><span style="font-weight: 400;">UnitedHealth and other publicly traded insurers like Anthem, Aetna and Humana have reported financial losses on their exchange business since 2014, the first year they went online. Some of these companies have even </span><a href="https://web.archive.org/web/20160818073128/http://www.usatoday.com/story/news/nation/2016/03/31/insurers-cut-commissions-restrict-when-and-what-plans-people-buy/82210946/"><span style="font-weight: 400;">halted commissions to insurance brokers</span></a><span style="font-weight: 400;"> for sales of exchange policies as a way of discouraging more people from choosing their products.</span></p> <p><span style="font-weight: 400;">The Blue Cross Blue Shield Association, which licenses that brand name to insurers across the country that dominate the exchange sector, released data this month illustrating how the customers who signed up via the marketplaces are </span><a href="https://web.archive.org/web/20160818073128/http://www.huffingtonpost.com/entry/obamacare-enrollees-are-sick_us_56face7be4b0143a9b497571"><span style="font-weight: 400;">sicker and more expensive</span></a><span style="font-weight: 400;"> than the firms' pre-Obamacare policyholders. The insurance ratings firm A.M. Best </span><a href="https://web.archive.org/web/20160818073128/http://www.businesswire.com/news/home/20160414006041/en/A.M.-Briefing-ACA-Participation-Boosts-Pressure-Blue"><span style="font-weight: 400;">also reported</span></a><span style="font-weight: 400;"> this month that the exchange business is creating financial pressure on Blue Cross Blue Shield companies.</span></p> <p><span style="font-weight: 400;">In spite of UnitedHealth's losses on the health insurance exchanges, the company still enjoyed</span><a href="https://web.archive.org/web/20160818073128/http://www.bloomberg.com/news/articles/2016-04-19/unitedhealth-profit-beats-estimates-fueled-by-tech-unit-optum"><span style="font-weight: 400;"> a profitable first quarter</span></a><span style="font-weight: 400;">, beating analysts' projections for earnings per share.</span></p></div> <script></script> <iframe style="display: none;"></iframe> <script class="article-bottom-ad-script-template" type="text/template"> </script> 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