Back in the summer of 2016, as Obamacare rates were being set for the 2017 plan year, we repeatedly argued that the entire system was on the "verge of collapse" as premiums were soaring, risk pools were deteriorating and insurers were pulling out of exchanges all around the country leaving many Americans with just a single 'option' for health insurance (see "Obamacare On "Verge Of Collapse" As Premiums Set To Soar Again In 2017"). And while Democrats may be all too willing to quickly dismiss our analysis, just a few weeks ago we suggested that they should at least listen to the warnings of the CEO of one of the country's largest health insurers who said that Obamacare is in a "death spiral." In speaking with the Wall Street Journal, Aetna CEO Mark Bertolini said, among other things, that the "risk pools are deteriorating in the ACA" to a point that it would inevitably result in more withdrawals this year. Per The Hill: "It's not going to get any better; it's getting worse." "That logic shows just how much the risk pools are deteriorating in the ACA," Bertolini said. He added: "I think you will see a lot more withdrawals this year. ... There isn't enough money in the ACA as structured, even with the fees and taxes, to support the population that needs to be served." "It is in a death spiral," he said, but did not say whether Aetna would participate in the exchanges in 2018. All that said, we suspect that certain members of Congress don't like to read all that much and are more "visual learners." As such, we thought the following graphics, which clearly depict the epic collapse of Obamacare, may help lend some perspective to Democrats who are vehemently fighting to preserve a system that is clearly very broken. Before we get into what could happen (and most likely will happen) over the next couple of years, here is a look at what has already happened to insurance coverage "options" for consumers across the nation. As can clearly be seen, coverage options, particularly for people of the southeast and mid-west, have been decimated. (Dear Chuck Schumer and Nancy Pelosi, please note that all of the below happened well before President Trump moved into the White House). Charts per Bloomberg: And while some state-run marketplaces have been able to maintain decent coverage options, courtesy of high population densities in CA and NY no doubt, the federally run marketplaces are abysmal. Unfortunately, things are likely to get even worse in 2018 even if Trump leaves subsidies in place. Humana has already announced they won't offer marketplace plans in 2018, a move which will result in 1,000s of people in Tennessee not having a single health insurance option starting 1/1/18. Meanwhile, Anthem has also signaled they may exit all exchanges next year as well which would leave another 250,000 consumers with no health insurance options. But sure, Republicans are trying to 'ruin' healthcare in America.
Trump Tax Reform Plans Put These ETFs in Focus.
With Republicans backing off a demand for money to fund President Donald Trump’s border wall in the upcoming spending bill, Fox News is stepping in with some ideas. “Fox & Friends” host Brian Kilmeade spoke with Republican strategist Noelle Nikpour, who suggested private funding for the wall. In a video clip Media Matters posted online, Nikpour said: “Donald Trump is a negotiator, he’s a deal maker. And everybody knows this. And here’s something that’s kind of interesting: If I were advising Donald Trump, I’m a national fundraiser, I would say, ‘You know what, here’s an idea, why don’t you see if you can’t get it privately funded?’ Privately funded, meaning, if you donate a certain amount ― let’s just say that the number is $12 billion to get this wall implemented, all right? So you had the $12 billion dollar figurehead, and you go to donors, you go to different people and you say, ‘Look, if you will contribute towards this privately, look what your money’s going to. I mean, what a better deal that you’re a part of this.’” Kilmeade suggested that those who pay could get a tax break, and the wall could have corporate sponsors. “This wall brought to you by Modell’s. Or Aetna,” he suggested. “Why not do it?” “Yeah yeah yeah, and look at you know what Ted Turner I think gave a billion dollars to the U.N. Foundation,” Nikpour said. “And look at this, I don’t think he paid federal taxes for a lifetime.” Turner donated $1 billion to the United Nations in 1997, paid out over a period of nearly two decades. It’s not clear if he has been able to avoid federal taxes “for a lifetime” because of it. -- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website.
Authored by Mike Shedlock via MishTalk.com, Nearly the entire state of Tennessee has a single Obamacare provider. In sixteen counties, none of this year’s providers want to do business. Mississippi, Alabama, South Carolina, Oklahoma, Alaska, and Wyoming are states where there is only a single provider for the entire state. Iowa is likely to be covered by a single provider next year. Most of North Carolina, Florida, Missouri, and Arizona are also in a single-provider situation. Enrollment for 2018 starts in November. Will the problem be fixed by then? If not, What Happens if Places Have No Obamacare Insurers? The markets created by the Affordable Care Act have always relied on the voluntary participation of private companies. If the government set up the right conditions for the market, the thinking went, insurers would want to jump in. But, as Sarah Kliff at Vox.com has reported, the law contained no real backup plan if that vision didn’t work out. So far, there are parts of Tennessee where none of this year’s insurers want to sell insurance next year. Other counties have only one carrier, and in some of them, that carrier is looking shaky. If insurers do all decide to exit a market, no one is exactly sure what will happen next. Some experts have brainstormed about possible workarounds, but all would entail uncharted legal territory. Senator Lamar Alexander of Tennessee, the state currently at greatest risk of bare counties, has introduced a bill that would create options for customers shut out of their Obamacare market. But even if Congress passed such a law, regulators would have to work very fast to make anything happen before next year’s enrollment period, which begins in November. No Backup Plan Vox asks What if Obamacare Insurers Falls to Zero? Multiple sources tell me that White House staff held a meeting today to discuss cost-sharing reduction subsidies — that $8 billion Obamacare program whose fate still hangs in limbo. Ending these payments could “blow up” the health law’s marketplaces, but President Trump has so far waffled on what he’ll do about the issue. The meeting didn’t include any outside advisers or industry officials, only administration staff. Right now there are 16 counties in Tennessee where no health insurer wants to sell Obamacare coverage. Iowa could be next: Half its Obamacare insurers announced this month that they would no longer participate in the marketplace. That leaves 94 of the state’s 99 counties with just one insurer — and regulators there aren’t totally sure that plan, Medica, will stick around. “We don’t have any commitment from the two carriers that remain that they will be there,” says Doug Ommen, Iowa’s insurance commissioner. “They’re not required to file with us until June. Certainly we’re hopeful, but unless Congress acts, our market will continue to be very unstable.” What happens if no one wants to sell coverage? Does the law have any fallback plan? The short answer is no. There is no backup plan for places where no insurer wants to sell Obamacare coverage. Even before the election, some big insurers had decided that the Obamacare marketplaces were not good for their bottom lines. Aetna and UnitedHealth mostly withdrew in 2016, leaving lots of places with just one insurer. Since the election, health insurers have only gotten more skittish. Humana announced in February that it would no longer participate. That left those 16 Tennessee counties without any plans, and many more counties with just one option. Ryan’s Folly The articles mentioned that Trump could call up providers and bully them into offering coverage. But does that make any sense from a party that wants to Kill Obamacare? The system is set up to implode and there is no point to doing anything until it does. After an implosion, there will be bipartisan support to do something. Right now there is no bipartisan support to do anything. The folly of House Speaker Paul Ryan’s ill-fated attempt to fix the problem is readily apparent. His poor decision to attempt to fix the unfixable accomplished nothing useful, but it did move partial ownership of the problem to Republicans.
Aetna (AET) reported earnings 30 days ago. What's next for the stock? We take a look at earnings estimates for some clues.
Shares of health insurer Aetna Inc. (AET) underperformed over the past one year.
Another one bites the dust.
Aetna said it will not offer individual coverage in Iowa in 2018, offering a hint the large insurer plans to further retreat from offering plans on public exchanges under the Affordable Care Act.
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The Zacks Analyst Blog Highlights: Aetna, BHP Billiton, Sprint, Capital One Financial and BlackBerry
The Zacks Analyst Blog Highlights: Aetna, BHP Billiton, Sprint, Capital One Financial and BlackBerry
The CMS has decided to raise 2018 Medicare Advantage more than expected.
Humana (HUM) reported earnings 30 days ago. What's next for the stock? We take a look at earnings estimates for some clues.
Teladoc's (TDOC) services will complement JeffConnect, the telehealth program of Jefferson Health.
**Should-Read: Craig Garthwaite and John A. Graves**: _[Success and Failure in the Insurance Exchanges]_: "President Donald Trump and large fractions of the Republican majority... campaigned on an explicit pledge to repeal and replace the ACA... [Success and Failure in the Insurance Exchanges]: http://www.nejm.org/doi/pdf/10.1056/NEJMp1614545 >...At least part of the impetus for these promises is a general belief that the ACA’s state-based insurance marketplaces are unworkable and are resulting in higher prices and fewer choices. In 2016, the ACA marketplaces facilitated coverage purchases for approximately 13 million people nationwide. But many prominent national insurers have struggled... UnitedHealth... Aetna.... >Smaller and more focused insurers are earning profits in the new market and are aggressively entering new geographic areas.... Centene and Molina have both had financial success in the ACA marketplaces.... These two insurers have historically operated in the Medicaid managed-care market.... >New plans had substantially lower premiums than their local competitors... were more likely to have experience with Medicaid managed care but less likely to have direct experience in the markets they entered. This finding is consistent with the existence of a functioning market in which firms that were initially successful are moving into new geographic areas.... >The available data reveal patterns of...
Anthem Inc. (ANTM) is planning to scale back its participation on loss making public exchange business for 2018, as per analysts who met management.
After a stunning healthcare defeat last week, delivered at the hands of his own party no less, Trump took to twitter to predict the imminent 'explosion' of Obamacare. ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE. Do not worry! — Donald J. Trump (@realDonaldTrump) March 25, 2017 The Democrats will make a deal with me on healthcare as soon as ObamaCare folds - not long. Do not worry, we are in very good shape! — Donald J. Trump (@realDonaldTrump) March 28, 2017 As it turns out, that 'explosion' could come faster than anyone really expects as legislators and health insurers have to make several critical decisions about the 2018 plan year over the next 2 months which could seal Obamacare's fate. As the Atlanta Journal Constitution points out today, the Trump administration has until May 22nd to decide whether they will continue to pursue the Obama administration's appeal to provide subsidies to insurers who participate in the federal exchanges. Of course, any decision to remove those subsidies would likely result in yet another massive round of premium hikes and further withdrawals from the already crippled exchanges where an astounding number of counties across the country have already been cut to just 1 health insurance provider. And, as we've pointed out before, higher rates = lower participation = deterioration of risk pool = higher rates....and the cycle just repeats until it eventually collapses. As background, in 2014, House Republicans sued the Obama administration over the constitutionality of the cost-sharing reduction payments (a.k.a. "taxpayer funded healthcare subsidies"), which had not been appropriated by Congress. Republicans won the initial lawsuit but the Obama administration subsequently appealed and now Trump's administration can decide whether to pursue the appeal or not. One key to insurers selling plans in the marketplace are reimbursements they receive called cost-sharing reductions. These aren't the same as the tax credits that people receive to help pay their premiums; it is financial assistance to help low-income people pay their out-of-pocket costs, such as deductibles. The Congressional Budget Office projected those payments would add up to $7 billion this year and $10 billion in 2018. But for insurers, there's a question over how long that money will be delivered, due to an ongoing political and legal dispute about whether the cost-sharing money should be distributed at all. In 2014, House Republicans sued the Obama administration over the constitutionality of the cost-sharing reduction payments, which had not been appropriated by Congress. The lawmakers won the lawsuit, and the Obama administration appealed it. Late last year, with a new administration on the other end of the suit, the House sought to pause the proceedings — with a deadline for a status update in late May. The Trump administration and House lawmakers have to report to the judge this spring. If the Trump administration drops the appeal, it would mean the subsidies would stop being paid — a huge blow to the marketplaces and millions of people. If lawmakers wanted the payments to continue, they would have to find a way to fund them. One opportunity for that is coming up fast, the continuing resolution that must be passed by April 28. If the Trump administration continues the lawsuit, it will be in the odd position of fighting its own party. The CBO estimates the payments would total roughly $10 billion in 2018. As we've noted before, several large insurers, including UnitedHealth Group and Aetna, have already made the decision to exit Obamacare due to financial losses. Now, Molina Healthcare is also pondering whether it would be able to continue to participate in the absence of federal subsidies. Big insurers like UnitedHealth Group and Aetna have mostly left the individual market over the years, citing financial reasons. Several counties across the country only have one insurer offering ObamaCare plans. Now Molina Healthcare is signaling it may downsize its presence in the market, or pull out altogether, if Congress or the administration doesn’t act to stabilize it. Molina has 1 million exchange enrollees in nine states this year. “We need some clarity on what’s going to happen with cost-sharing reductions and understand how they’re going to apply the mandate,” said Molina CEO Dr. Mario Molina. Asked if Molina would leave ObamaCare if the payments are stopped, the CEO said: “It would certainly play into our decision. We’ll look at this on a market-by-market basis. We could leave some. We could leave all.” Mario Molina, chief executive of Molina Healthcare, predicted that if the cost-sharing reductions are not funded, it could result in premium increases on the order of 10 to 12 percent. While all this uncertainty swirls, health insurers must decide — soon — whether to make rate filings to sell insurance in 2018. The deadline varies by state, but for those that have marketplaces run by the federal government, it is June 21. Filing doesn't mean that insurers will participate; they'll have months more to negotiate and could still drop out. But it's the first step toward offering plans in 2018 and should provide a signal about what the marketplaces are likely to look like. Meanwhile, it seems pretty likely that Obamacare couldn't survive another collapse in coverage like we saw in 2017 (charts per the New York Times): 2016 healthcare insurance carriers by county: 2017 healthcare insurance carriers by county: The first step is admitting you have a problem.
Hospital stocks have dipped again amid reports that House Republicans will continue to pursue their health care reform plan in 2017.