Aetna fully supported ACA until their merger was blocked. Maybe that was a huge coincidence (lol)
-
Hey Guest. Check out your NeoGAF Wrapped 2025 results here!
Aetna to pull out of most Obamacare exchanges
- Thread starter Vanillalite
- Start date
- Status
Aetna fully supported ACA until their merger was blocked. Maybe that was a huge coincidence (lol)
Dreams-Visions
Member
....oh.
RoninChaos
Member
Aetna is scummy anyway. We have them at work and I can't see my doctor right now because of an argument between them. My doctor works at a non profit and Aetna wants to reduce payouts to their office by 90 percent. They're greedy fucks.
Clockwork
Member
Yeah, you're the expert. Look at every major insurer right now. The majority of the big players are either reducing or eliminating their ACA footprint. It's not a profitable endeavor.
Btw, the merger goes to court in December. It could still be approved.
hydrophilic attack
Member
Isn't the exchange just a place where you can compare different policies buy the one that fits you? Surely, not all insurance companies on the exchanges are unprofitable? If they were, shouldn't the magic of the market change the policies in terms of rates and coverages and conditions until it's profitable for enough insurance providers? So, if some providers manage to be profitable, but Aetna cannot on the exchanges, doesn't that just mean that Aetna don't offer good enough policies to profitably compete in a marketplace where consumers are given enough information to make informed decisions? So, Aetna getting out is just the system working as intended, as they are too shitty to compete and not "the latest blow to Obamacare".
Except that was literally the deal though. Insurers were supposed to accept these high risk pools via the exchanges and in return there would be no public option that threatened the survival of the entire private insurance market. They always knew they would take losses from the individual market exchange plans, especially early on when people who either couldn't afford insurance or were denied due to preexisting conditions started signing up in droves. It was always going to take time for costs to balance out, remember we're only in year 3 of the exchanges. Meanwhile, they've continued to thrive in the post-Obamacare world, making money hand over fist largely due to taxpayer dollars funneled through Medicare and Medicaid.
So no, you're wrong, this is absolutely about punishing the Obama administration for blocking their mergers. It will backfire though because the longer this goes own, the easier it will be to politically justify a public option. The law will never be repealed whole sale, that ship has long sailed.
From Manmademan's own link, from February (the merger was challenged in July):
They already said in February that they were going to withdraw from some states.
Other insurers are withdrawing as well, and it is not because of "spite".
ACA was a deal between Democrats and to try to convince some Republicans to join because it mimicked Romneycare. You are wrong if you think a public option was used as a threat to the insurance companies.
As someone else said, the whole reason they're in it to begin with is because the government gave them an out and decided to not set up a public option that would compete with them. There have definitely been some issues with them by counting on so many people who were sick actually utilizing healthcare services once they got coverage (who could've predicted that?!) but they also lucked out by having cowardly politicians who fought to keep them in business.
Shake Appeal
Member
"A damn mess" doesn't begin to cover it, sadly.
The U.S. Has Gone To War For Much Less Than What Healthcare Is Doing To America
poppabk
Cheeks Spread for Digital Only Future
You have it backwards, Aetna were offering policies that were too good hence they were paying more out than they were taking in.
Clockwork
Member
It had nothing to do with punishing Obama. Aetna is not the only carrier dropping out of ACA exchanges. It simply isn't profitable. A simple Google search reflects this. Aetna are not the only ones.
The deal was never "take all of our high risk folks and deal with it" it was you get the high risk people, but also a bunch of healthy people that now need to be covered or they will see penalties. Except the results were very lopsided in that these companies took on a lot of very sick people, they didn't have the healthy ones to subsidize those losses. There were other failures (product/pricing strategies, etc) but in the end it still ends up being the same thing. It's not profitable. This isn't the case for all markets, but the ones that are I can't see how you could say an exit was unexpected.
Edit: Like I said anyway, Aetna and Humana are still pursuing a merger. It's not a blocked/done deal. Humana has a ton of government business (Medicare and Tricare) that has been awarded to them. Do you think part of their strategy is to shoot themselves in the foot prior to the upcoming trial?
hydrophilic attack
Member
So why don't they just adjust so they can make a profit? Surely, not everyone is making a loss?
Clockwork
Member
Yes, based on the views presented in this thread I am sure a huge premium increase is a terrific solution.
The vast majority of those jobs are going to be answering phones and back office clerical work. Those jobs, and many others would continue to exist to some extent with a public option or a public insurance company. Someone would need to manage it.
At any rate, there is no way that we should maintain the current shitty insurance system solely to save jobs. Put a retraining program in place if needed, but the current insurance program is to expensive to maintain it just as some form of welfare program for the people currently working in the system.
exmachina64
Banned
What are people supposed to do for healthcare in the intervening years?
Outdoor Miner
Member
Obamacare is like a Bethesda game. Needs mods and tweaking to become great and you wonder how it ever made it out as is but you're still glad it did.
D'ultimate
Member
It's true Aetna is not the only company pulling out, I believe United Healthcare is another but like others have said, they knew this was how it was going to be from the get go. It's part of what they signed up for.
Over time as the country becomes healthier these losses would be diminished. They're too fucking greedy to wait it out and to offer a competitive product on the marketplace.
Fuck 'em!
Over time as the country becomes healthier these losses would be diminished. They're too fucking greedy to wait it out and to offer a competitive product on the marketplace.
Fuck 'em!
JustenP88
I earned 100 Gamerscore™ for collecting 300 widgets and thereby created Trump's America
I can't wait until the government grows the balls to "starve the beast" with regard to private insurers the same way Republicans talk about education, Medicaid and social security. These people are making money, hand over fist, off the suffering of Americans and I'm getting real tired of conservatives sympathizing with them.
UnemployedVillain
Member
Another issue not talked about is the Supreme Court decision that allowed states to opt out. Insurance only works when the burden is spread out, and allowing huge chunks to opt out of ACA also contributed to some of these issues
Jibbajabbawockky
Member
Not really. They're getting out because the "business" they had was making them lose money. So, as a publicly traded company, its probably pretty smart to get out of some business venture that's losing you money.
The issue with the government getting more heavy handed or involved in insurance is that leads to them basically getting way more involved in every facet of the healthcare industry which is a humongous part of the US economy. Any kind of single payer or universal healthcare initiative is going to be hammered by conservatives as some kind of socialist government seizure of a huge fraction of the economy.
Those who did't see this coming.
If you can make money, and you are losing money by participating in a program why would you as a business that has to turn a profit for Wallstreet.
It's not just Aetna either.
Even people outside of the ACA are going to be worst off, b/c insurance rates will surely go up again.
If you can make money, and you are losing money by participating in a program why would you as a business that has to turn a profit for Wallstreet.
It's not just Aetna either.
Even people outside of the ACA are going to be worst off, b/c insurance rates will surely go up again.
LegendofJoe
Member
It's funny to me that insurance plans are the recipients of so much anger when the medical profession via the AMA continues to lobby to set their own reimbursement rates and the pharmaceutical industry won't let the government negotiate drug prices.
Do people honestly think insurance companies would be opposed to price regulation? Because that's the core root of the problem when it comes to healthcare. There isn't enough power on the payer side to drive down costs.
Edit: It's also why as counter-intuitive as it seems the Justice Department is being foolish blocking the mergers of major insurance companies. The ACA was crafted to encourage that to give payers (i.e. insurance companies) more leverage over providers to drive costs down.
Do people honestly think insurance companies would be opposed to price regulation? Because that's the core root of the problem when it comes to healthcare. There isn't enough power on the payer side to drive down costs.
Edit: It's also why as counter-intuitive as it seems the Justice Department is being foolish blocking the mergers of major insurance companies. The ACA was crafted to encourage that to give payers (i.e. insurance companies) more leverage over providers to drive costs down.
God Dayumm
Banned
So insurance companies have lower profits, while working class people are paying higher premiums. Who does this benefit again?
LegendofJoe
Member
They're dropping individual plans on the insurance marketplace. This will have little to no effect on large-group plans, which you are likely covered under via your employer.
I see. Thank You.
Yup, of course when you have a generation of people who have never been able to afford to see the doctor unless things were dire, then the first few years will be more expensive as they utilize services for the first time in forever. I just can't wait for the day people realize that there's a better way and that we don't have to be at the mercy of these shitty insurance companies.
gamechanger87
Member
Based on my first hand interactions with the DOJ for HSR and merger approvals, it is 100 percent a political entity. The worker bees there do the right work, but the ultimate decision makers (Commissioners) who are put in that spot by the administrations are politically motivated. Their decisions usually have little to do with the actual work done.
Manmademan
Member
When has driving an industry towards monopoly ever driven costs down?
LegendofJoe
Member
Ever looked at what single payer (or rate setter) countries spend on healthcare?
Manmademan
Member
single payer countries aren't using publicly traded private companies as their sole source of healthcare coverage.
R10Neymarfan
Member
Private insurance is still gonna exist as an option for anyone that doesn't want universal health coverage. Companies will thrive, they just won't make record breaking profits.
LegendofJoe
Member
They aren't and neither are we with Medicare and Medicaid. The government having the power to control rates, i.e. having monopoly power, is the difference between us and other countries that spend much less on healthcare.
Manmademan
Member
Medicare and Medicaid are a completely different ball of wax. We aren't talking about those, because the average citizen can't use them (there are age restrictions on the one, and income restrictions on the other). They also aren't run for profit and have significant oversight into their operations.
What we're talking about here is allowing the five largest insurers in the country to merge down to three, since this is what the federal government shot down and what you classified as a mistake.
Medicare for everyone as single payer is fine. Aetna for everyone since all competition has been eliminated due to mergers is a disaster, and its ALWAYS a disaster.
LegendofJoe
Member
Think of how highly regulated utility companies are. In an ideal scenario the government would set reimbursement rates and cap what insurance companies are allowed to charge customers. Some of the latter was already put in place with the ACA but the government has not been nearly aggressive enough when it comes to policing insurance premium increases. A strong government would be able to make an Aetna, United, Kaiser, Anthem, etc. for all work just fine.
A strong government is what we obviously lack.
Clockwork
Member
Insurance is only one piece of the puzzle.
When doctors/hospitals and pharmaceutical companies are charging many times over what patients in other parts of the world pay then the answer can't simply be "make sure those big bad insurance companies don't charge us too much premium".
Manmademan
Member
Many utility companies are owned by municipalities. They aren't private in the sense that Aetna is. Since I don't know where you are and haven't used your utility, I can't comment.
A better comparison is to look at cable companies given regional monopolies over television and internet services.
I don't know a single person that's happy that they HAVE to put up with comcast and comcast's terrible practices. And you're ignoring that companies LIKE comcast will lobby the hell out of local, state, and federal politicians to get laws passed that are favorable to them, rather than the other way around.
It's a terrible idea, any way you look at it. eliminating competition and driving the insurance industry towards 1 or 2 huge suppliers is not a good thing, and its never been an good thing in any industry.
I think the other thing we need to do is pull back and look at exactly what Obamacare's goals were and how far it's gone towards accomplishing those goals.
- Stop insurers from fucking over sick people
- Expand coverage to millions of uninsured folks
- Do those first two without exploding medical costs and insurance premiums
I think we can safely say that based on those measures, it's been a resounding, almost unfathomable success. The only one you could even argue is the third, however, you'd lose that argument. In the absolute worst cases, costs are rising at relatively the same rate they did pre-Obamacare. In the best cases, they are actually decreasing, which is something we've literally never seen before in the history of US healthcare. Step back from the ledge everyone, things are just fine in Obamacare land and will only get better when Hillary and the Dems take back Washington.
- Stop insurers from fucking over sick people
- Expand coverage to millions of uninsured folks
- Do those first two without exploding medical costs and insurance premiums
I think we can safely say that based on those measures, it's been a resounding, almost unfathomable success. The only one you could even argue is the third, however, you'd lose that argument. In the absolute worst cases, costs are rising at relatively the same rate they did pre-Obamacare. In the best cases, they are actually decreasing, which is something we've literally never seen before in the history of US healthcare. Step back from the ledge everyone, things are just fine in Obamacare land and will only get better when Hillary and the Dems take back Washington.
Shake Appeal
Member
Working- and middle-class people, who are no longer being sold exploitative junk plans, and people who could not previously afford health insurance.
Also children, dependents under 26, early retirees, women, people with pre-existing conditions, people with Medicare, most people who takes prescription drugs, anyone who has ever had to interact with a health insurance company, and anyone who has ever been denied coverage because of annual or lifetime limits.
So hundreds of millions of people, honestly.
The numbers on medicals bills are always insane.
Hospital/doctor charge $1,000,000.000
Insurance pays. $20.00
And...we're good!
um..ok!
Shake Appeal
Member
This is true. Health insurance is stupidly expensive in America because healthcare in America is stupidly, unbelievably, even downright criminally expensive.
Clockwork
Member
The one thing that could be said is that allowing for these kinds of mergers gives the insurers more clout when it comes to negotiating provider payments/fee schedules and things like drug pricing.
*shrug*
You left out the part that you get hit with a ridiculous fine if you don't get one of these shit plans for the year, plans people can't afford and barely cover the surgeries or procedures they need done. It's not all sunshine and rainbows.
I never understood the "people who couldn't afford plans in the past"
As if the cheap plans cover anything worth a damn. The plans are not cheap, if anything they cost more.
Shake Appeal
Member
Having one big insurance company that can strongarm providers on behalf of the public good would be super.
But having one big, profit-driven, shareholder-beholden insurance company that can strongarm everyone would be very, very wretched.
Shake Appeal
Member
All of these things are not the fault of the Affordable Care Act. In fact, they're consequences of the ACA not being a powerful or radical enough piece of legislation; it's a Republican-inspired, market-based solution that has to conform to the realities of the absolutely batshit and awful health sector.
It is not all sunshine and rainbows, no. But it is an umbrella in the downpour of bullshit that is American healthcare, and it's a good one.
Manmademan
Member
exactly. it's not like "what would happen if there was a monopoly" is a hypothetical, there are well documented historical examples of why this is a horrible idea.
Standard Oil, US Steel, AT&T, and DeBeers in theory have or had plenty of leverage to control prices to the lowest possible point because there WAS no competition for these entities.
In practice these companies engaged in abusive practices, sky high prices, and had no reason to care what the impact of their policies on consumers were, since consumers had no choice to go elsewhere.
There is a reason the US breaks up monopolies rather than allow them to repeat (though DeBeers still exists and isn't nearly as powerful- have you looked at diamond prices lately?)
Fuck Aetna, they're horrible. They were regularly denying my sister in law coverage of her birth control even after the mandate that all insurance had to cover bc. They dragged their feet for years until threatened over it. When my bro left them a bad review about it on the exchange they deleted it, lol.
A lot of people think this will help push the public option forward, but I'm more worried it's going to push republican's efforts to outright repeal the ACA all together.... Democrats better get their act together and win back seats in congress to help fix this. What a fucking shame that we didn't have a public option to begin with in Obamacare.
A lot of people think this will help push the public option forward, but I'm more worried it's going to push republican's efforts to outright repeal the ACA all together.... Democrats better get their act together and win back seats in congress to help fix this. What a fucking shame that we didn't have a public option to begin with in Obamacare.
- Status