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Morning Briefing

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Thursday, Nov 3 2016

Full Issue

Anthem May Pare Its Health Law Offerings If Profits Don't Improve In 2017

Chief Executive Officer Joseph Swedish said he will be watching for significant changes that are aimed at improving the sustainability of the marketplace. If such changes aren't evident, the company will reassess its level of participation in the federal exchanges.

U.S. health insurer Anthem Inc on Wednesday raised the prospect of smaller participation in the individual Obamacare exchanges in 2018, saying it would have a market-by-market strategy that hinges on 2017 profitability. The company said that losses due to sicker-than-expected customers in its individual Obamacare plans were a bit less than foreseen in the third quarter and that it was planning for a slight profit in that business next year. (11/2)

The insurer said that 2017 is a critical year as it evaluates its plans for the business. If there aren鈥檛 improvements next year, including regulatory changes to the health-law exchanges, 鈥渨e will likely modify our strategy in 2018,鈥 said Chief Executive Joseph R. Swedish in a conference call with analysts. He said the insurer will look closely at, and reconsider its offerings in, the regions in which it offers health-law plans. Anthem said its ACA exchange plans will show a mid-single-digit loss for 2016, but said it is aiming for a slim profit next year. (Wilde Mathews and Hufford, 11/2)

Insurance company Anthem on Wednesday said it could pull back on its participation in ObamaCare in 2018 if changes are not made to make the market more sustainable.聽Other large insurers, such as Aetna, UnitedHealthcare and Humana, have already pulled back, citing financial losses on the ObamaCare marketplaces from a smaller and sicker group of enrollees than expected.聽In 2018, Anthem says it could join its rivals. Like the others, Anthem could drop off in some areas while staying in others. (Sullivan, 11/2)

Health insurer Anthem Inc., which has so far stuck with the Obamacare markets as rivals pulled back, said it may retreat in 2018 if its financial results under the program don鈥檛 improve next year. Anthem鈥檚 comments up the stakes for the Obama administration as the enrollment season for 2017 Affordable Care Act plans begins, with consumers already facing fewer choices and higher premiums in many markets. 鈥淚f we do not see clear evidence of an improving environment and a path towards sustainability in the marketplace, we will likely modify our strategy in 2018,鈥 Anthem Chief Executive Officer Joseph Swedish said on a call Wednesday discussing third-quarter results. 鈥淐learly, 2017 is a critical year as we continue to assess the long-term viability of our exchange footprint.鈥 (Tracer, 11/2)

The health insurer Anthem warned Wednesday that it could retreat from the Affordable Care Act marketplace in 2018. The company would consider withdrawing from the marketplace if its financial results from marketplace plans don鈥檛 improve next year, CEO Joseph Swedish said on a call Wednesday detailing the insurer鈥檚 third-quarter earnings. Swedish said 2017 will be a 鈥渃ritical year鈥 in determining the insurer鈥檚 plans for the exchanges going forward. (McIntire, 11/2)

Anthem on Wednesday said its profit for the third quarter of 2016 fell nearly 6% as higher medical claims and expenses related to its pending tie-up with Cigna squeezed earnings.Anthem CEO Joseph Swedish also said results in the insurer's individual ACA business 鈥渨ere disappointing鈥 due to low membership growth and higher than expected medical costs from members with chronic diseases. If the marketplace does not soon show progress toward sustainability, Anthem will likely re-evaluate its 2018 participation, he said. (Livingston, 11/2)

Anthem鈥檚 third-quarter earnings slid nearly 6 percent and missed Wall Street expectations, as rising medical costs countered revenue growth and some cost cutting for the nation鈥檚 second-largest health insurer. The Blue Cross-Blue Shield insurer also updated on Wednesday a 2016 forecast that falls short of analyst forecasts. (Murphy, 11/2)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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