Aetna could be forced out of Obamacare: CEO

[Jesus Malverde]

Source: CNBC

Medicare Advantage is too big now: Aetna CEO

Aetna CEO Mark Bertolini told CNBC on Wednesday that Obamacare has failed to attract the uninsured, and he offered a scenario in which the insurance company could be forced to pull out of program.

The company will be submitting Obamacare rates for 2015 on May 15.

"Are they going to be double-digit [increases] or are we going to get beat up because they're double-digit or are we just going to have to pull out of the program?" Bertolini asked in a "Squawk Box" interview from the World Economic Forum in Davos, Switzerland. "Those questions can't be answered until we see the population we have today. And we really don't have a good view on that."

He said that so far, Obamacare has just shifted people who were insured in the individual market to the public exchanges where they could get a better deal on a subsidy for coverage. "We see only 11 percent of the population is actually people that were firmly uninsured that are now insured. So [it] didn't really eat into the uninsured population."

Read more: http://www.cnbc.com/id/101354183

[Keefer]

1. Any truth to this?:

"We see only 11 percent of the population is actually people that were firmly uninsured that are now insured. So didn't really eat into the uninsured population."

[DonViejo]

4. Does this article help you any?...

One I posted on the 16th:

Don’t believe the hype: Health insurers think Obamacare is going to be fine

http://www.democraticunderground.com/1251348609

ON EDIT:

How about this one...

6 Million People Have Enrolled In Medicaid Since Obamacare Launched

http://www.democraticunderground.com/1251349832

[Keefer]

8. Thank you. n/t

[DonViejo]

9. You're very welcome, of course! eom

[PSPS]

13. Medicaid isn't Obamacare

What he's talking about is that not enough younger and healthier people may enroll for coverage through exchanges, thus jeopardizing the creation of a reasonable pool of risk. Medicaid enrollees are already fully-subsidized recipients of medical care and, thus, are not part of this scenario (i.e., they can't be considered part of a general risk pool.)

[davekriss]

46. I get your point but

Medicaid expansion is too a part of Obamacare. "Medicaid isn't Obamacare" - well, neither are the Aetna, Blue Cross, etc., the myriad plans sold on the Exchanges.

However, I get your point about the less than ideal risk pools: May it usher in single-payer!!

[jtuck004]

10. He is stating what they are seeing as a company.. There are other companies all with

different populations. But it doesn't sound so very off of what little is being reported by other sources.

He is also being proactive, prepping the machine for the coming rate increases as they figure out better how to stick their hands in people's pockets, and how the government can help them do that.

[karynnj]

33. He sees just his company

A large percent of the uninsured were helped by expanded Medicaid.

One problem is how does he define "population". Assuming it is the people going through the exchanges and selecting AETNA, it may well be mostly people dropping expensive market plans for plans on the exchange. This is what the ACA wanted -- creating pools so individuals don't pay far more than large companies pay per person.

How this could hurt their rates is that they might speculate, at this point, that the uninsured are healthier than those who bought individual policies. The logic there might be that the cost was so high that more people who had reason to think they were likely to need expensive care would buy rather than "self insure" (not have insurance). There is no way they could have real cost estimates for a program that started 3 weeks ago! (In fact, for all companies, I suspect the first half year might have atypically high costs as people, denied care, visit doctors for the first time in years.)

As to pulling out of the program, I assume that in fact means dropping out of the individual market altogether. This would limit their business to big companies that use them. One downside is that would reduce their size. I have no idea what percent of their business is through companies vs through individual policies. Unless the latter was very small, I wonder if their loss of customers would also mean they represent a significantly smaller pool. If so, this could hurt their contracts with doctors and hospitals.

[kelliekat44]

43. They won't be "forced out." They may withdraw on their own. nt

[underpants]

2. Complete BS - "simpler"? 3%? BS they don't like the (ONLY) 20% MLR

For Obamacare to work better, it needs more flexibility and choice of insurance programs, Bertolini said. "We need to make it a lot more simpler for people. There needs to be more choice. When you get more choice, you make it more of a market and you get more people in the program."

As for Aetna, Obamacare plans make up 3 percent of its revenue, he said. "Whether or not there's a government bailout because we lose some money on members is irrelevant to us from our standpoint of our earnings."

--- none of that makes sense to base a decision like this on ----

Medical Loss Ratio --THIS is what the insurance companies don't like....oh and the fact that they have to market TO people now and not just have customers fall into their laps

https://www.healthcare.gov/glossary/medical-loss-ratio-MLR/

On edit - "simpler"? Since when have they ever made anything simpler for consumers to understand. Hell I worked for a non-profit who had an intermediary who handled our coverage because it was just too complicated to wade through and manage.

[csziggy]

15. Exactly - Aetna loves to deny coverage, and wants a huge profit

When Aetna was my husband's health insurance through his employer, we had more problems getting them to cover even pre-approved procedures than any other insurer we've had. They routinely denied the first claim, even from in-network doctors.

I was so relieved when his employer changed insurers - though the current one is not a lot better they are not as bad as Aetna was!

[elleng]

22. And they were always the most expensive

among all the plans offered by Federal Employees' Health Benefits Plan.

[King_Klonopin]

24. Yup. Notoriously awful coverage -- especially for mental health.

Squawk Box should be the tip-off. It's a soap box for
CEO's to piss and moan about "government" messing up
their wonderful companies. They suck. Only interest is
making profit, not healthcare for policy holders.

Good riddance. Dead wood like Aetna should be one of those
things that Obamacare prunes out of the sytem.

[Jesus Malverde]

32. And these are the partners the government chose to deliver health care to the people...nt

[pothos]

47. yupppp

+11111

[thelordofhell]

3. Poor Babies

Can't squeeze profits out of diseases and doctors anymore..........maybe you should have paid more attention to helping people before, dumbasses.......then maybe the government wouldn't have had to swoop in and make you actually accountable to people.

[Warren Stupidity]

5. Good. A public not for profit insurance system will be required.

[jsr]

35. Precisely.

[ellennelle]

6. bubble talk

i swear; these guys will say anything that pops into their pointy little haids.

truth just came out today, which may be why the guy is talking opposite.

6.3 folks have signed up for medicaid and CHIP since 10/1.

so, yeah, cry us a river, mr. bertolini; i'm so sure it will be much deeper and so much more real than the rivers of tears shed by the victims of your profiteering.

not.

[leftyohiolib]

7. oh no we "might" have to opt out ...... BOO!

call the press when you do opt out otherwise shut up and sit down

[shawn703]

11. And if they pull out what will happen to their membership?

People will flock to Aetna where they can pay more for less because they're such a sexy brand? What do they think they are, the fucking Armani of the insurance world?

[The Green Manalishi]

12. Throw the SOB in gizmo and waterboard his ass

And every other CEO who stands in the way of universal health care.

Anyone who does anything to prevent anyone from being covered for anything should be treated like an attempted murderer, only worse.

Bring the fucking guillotine back.

[SkatmanRoth]

14. Can we have single payer yet?

It is unacceptable for the government to force the citizens to supply a guaranteed profit to a private insurance company.

[another_liberal]

20. Exactly what I was thinking.

If the big insurance company fatcats can't make enough money to satisfy their greed, Single Payer's time has finally come. One more successful election cycle and we can really have affordable health insurance for all.

[bushwacker 5]

16. medicare advantage is too big now

Mark Bertolini CEO in 2012 his salary was 1.,3 million not including another 34.2 million in vested stock.Guys like this are the reason we need single payer and not for profit health insurance.

[antigop]

17. Read what Wendell Potter had to say....

http://www.huffingtonpost.com/wendell-potter/tomorrow-is-d-day-for-hea_b_4016306.html

[Jesus Malverde]

21. The Beginning of Disintermediation ... great read thanks!

[dem in texas]

18. Boo Hoo Poor Aetna

My daughter was one of the insured who shifted to new plan. Now she is paying $60 per month instead of $325 and has better coverage. She now has some extra money in her pocket to pay for other things she so desperately needs, like food and getting her car repaired. Fuck Aetna!

[godevil10]

30. Yes but, who is paying the rest of her bill? Isn't that the point?

Somebody has got to pay for this if not enough young healthy people, who are not eligible for subsidies, enroll. There is no free lunch here.

[karynnj]

36. The subsidy is paid by the government

This would mean that to the insurance company, a young person with a policy partly paid by a subsidy is no different than a young person with no subsidy.

I think it likely that this person's daughter is likely a young adult - but that is simply a guess.

[godevil10]

38. OK then who pay's the Government or

do we just print the money?? Oh I know tax the rich, yeah right. That darn money has got to come from someone, somewhere, right? Borrow it from China?

[karynnj]

39. The bill had various sources of savings

One of the largest is that the federal government has subsidized hospital treatment of the uninsured who could not pay. With everyone insured, there is a huge savings. Hospitals are the most expensive level of care, but emergency rooms are often the only option for people uninsured and too poor to afford regular healthcare. It is one of the reasons why the US pays nearly double the cost of healthcare than other industrialized countries - it is extremely inefficient.



Seems that you are far from home on the right, here on the left. What gives with the offensive username? Is this what you thought would make you fit in?

[godevil10]

41. I will not hold my breath until we see these savings.

Been there, done that on various government programs in my 72 years of experience. I will wager anyone here a dinner and drink that within 4-5 years ACA will be in desperate need of funding! Perhaps then we can do this thing right.

[Matariki]

50. What is your idea of doing it right?

[godevil10]

55. Ah ha, caught me

didn't you. Single payer and by doing it right I also mean understanding and planning for the massive dislocation and unemployment of the thousands and thousands of people employed in the health insurance industry when and if we do away with it.

[Matariki]

56. Wasn't trying to 'catch you'! Just wondered what you think is the best solution.

I'm with you on single payer to be sure. I'd like to see insurance taken out of the equation as it seems like money better spent on actual health care.

[godevil10]

57. I agree but, it is the transition

and all the dislocation that will be involved that scares me. We must (unlike the ACA) throughly plan for this transition and its consequences.

[hadrons]

19. Aetna is the Verizon of insurance companies ....

and Verizon sucks ass ... I hope Aetna leaves ACA because their customers would be better off without them

[yeoman6987]

54. Verizon?

I have had zero problems with Verizon and I have Verizon Fios and my cell phone is Verizon. Now talk about Comcast…that is a company that friends of mine complain about all the time.

[quakerboy]

23. Wouldnt that just be a shame

Ya know, my wife had Aetna through an employer a few years back.

We found out it was cheaper to see a dr, do labs, etc, through an independent physician, and never mention that she had insurance, than to use her insurance.

Kinda makes me feel less than sorry for them.

[OKNancy]

25. Aetna is suffering because of the competition... exactly what the ACA was all about

We bought though the market place. There were about 50 plans on the Bronze and Silver menu.
Aetna was always at the top of the price range and didn't offer better deductibles or co-pays.
I don't mean by a little bit either. They were a lot higher.

[JoePhilly]

28. YUP ... they hate actual competition.

[Herself]

29. Aetna was part of the reason we needed PPA

They approved medical treatment in the beginning, then denied the coverage later. Causing severe financial devastation for my family. They were crooks then, still are, and if they are gone, I hope they go bankrupt!

[orpupilofnature57]

26. Bailouts make for a lazy 1% .

[sendero]

27. I'm pretty sure...

... you assholes basically wrote this law. So if it isn't working to your satisfaction look in the mirror.

As for Aetna leaving, why do you talk about that as though it were a bad thing? Aetna is the lowest of the low. Good riddance.

[geek tragedy]

31. Aetna is a shitty, shitty company run by shitty human beings that provides

shitty 'coverage' to the people who pay it premiums. Worst of all the health insurance companies.

They're whining because their shitty shitty shitty practices aren't attracting people who have a choice in the matter.

[penultimate]

45. All the Aetna plans I have been offered pre-ACA have been crap and overly spendy

and on the exchanges they are all much higher priced than others in Texas.

[lovuian]

34. Medical Insurance companies are dinosaurs and making their last gasp

if you raise premiums double digit .....nobody is going to be able to afford you

and that is what the reality is

Insurance companies were raising rates higher and higher causing American health care costs to be driven higher and higher

this couldn't continue

the Government got a "brain" .....in one hand we have military expenses and the other we have healthcare (Medicare and Medicaid)
the American Healthcare costs were double what the other countries in the world are and they had better outcomes

Greed Greed completely destroys and the insurance companies greed has destroyed themselves

America can not continue healthcare management as they have done in the past years

it will eventually go to universal health for all

its a matter of economics...American GDP only has so much and we will have to make a decision and the Military industrial complex does not like getting smaller

Republicans are their worse nightmare and are on a steep spiral downward

[godevil10]

40. True but,

we are talking about getting rid of a whole large, national industry (health insurance) here in the U.S, by far larger than the auto industry, I would think. This will cause widespread dislocation and unemployment for thousands and thousands of people. We had better know what we are doing and how we are going to do this before we sign off on another 3000 page law that no one read, e.g the ACA.

Just MHO.

[BootinUp]

37. He spewing contradictory bs. FUD is another name for it.

[ellenfl]

42. let the insurance companies force us into medicare for all! eom

[orpupilofnature57]

48. Anthony Weiner's solution, a damn good one !!

Our nations wealth should go to our Health & Well-being .

[penultimate]

44. I noticed Aetna had the highest prices on the exchanges...

[orpupilofnature57]

49. And this is just another Off-shore ploy .

[BlueStreak]

51. It is bullshit. The young people don't pay much in premiums

They rate all the age groups separately. They make loads of money on the people who are in, and there will be millions more enrolling before the 2014 open enrollment ends.

Think about it. For many of the people buying ACA policies, the government is paying 70% of the premiums. Tell me what insurance company is going to walk away from that.

[madamesilverspurs]

52. That would be the same Aetna

that's leaned on employers to get rid of employees with sick family members? Yeah, no sympathy for the company. Scum.

[dem in texas]

53. Single Payer someday

Medicare used to be single payer until Bush added the Advantage program. This program started out giving the insurance companies about $1100 a year per customer. The amount is supposed to gradually decrease until it is equal to single payer Medicare. As the insurance payments are decreasing, some companies are pulling out of Medicare because it is not profitable. What it proves is that government single payer is cheaper than using insurance companies. We will probably go through the same thing with ACA. If other countries can have good medical care and at a lower cost, why can't the US? And the people in these countries live longer that we do.

High insurance premiums suck money right out the economy and ACA is a move to stop this. The US cannot sustain the system we have now. Same for student loans. After a student graduates, they are paying 4 or 5 hundred dollars a month in loan repayment. If they did not have the payment, they would be putting that money into our economy. These are really serious problems that have got to be addressed. ACA is far from being the product we need, but it is a start.

As far as low income people getting subsidies, if they didn't, they could not afford the insurance and would go to emergency or wait until they were so sick they had to go in the hospital, all paid for the taxpayer and it would end up costing more in the long run.

[Blue Idaho]

58. Huh?

Sorry but if you're out of the ACA aren't you pretty much out of the health insurance business?