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Thursday, Nov 19 2015

Full Issue

UnitedHealth Cuts Earnings Forecast, Raises Doubts About Future Participation In Health Law Insurance Marketplaces

This early morning disclosure by the nation's largest insurer highlights the difficulties insurers are having with the marketplaces created by the Affordable Care Act and will fuel concerns regarding the long-term sustainability of the exchanges.

UnitedHealth Group Inc. said it expects major losses on its business through the Affordable Care Act鈥檚 exchanges and will consider withdrawing from them, in the most prominent signal so far of health insurers鈥 struggles with the health law鈥檚 marketplaces. The disclosure by the biggest U.S. health insurer, which had just last month sounded optimistic notes about the segment鈥檚 prospects, will sharply boost worries about the sustainability of the law鈥檚 signature marketplaces, amid signs that many insurers鈥 losses on the business continue to mount. (Wilde Mathews, 11/19)

The nation鈥檚 largest health insurer said it was 鈥渆valuating the viability of the insurance exchange product segment,鈥 pulling back on its marketing efforts for individual exchange products for next year and 鈥渨ill determine during the first half of 2016 to what extent it can continue to serve the public exchange markets in 2017.鈥 The insurer sells individual plans on public exchanges in 24 states and covers more than a half million Americans in these plans. (Japsen, 11/19)

Insurers have struggled to profit from the government-run marketplace created by Obamacare. Anthem Inc. last month said some rivals were offering premiums too low to provide the coverage patients require and book a profit. 鈥淲e can expect other participants to guide to the same experience,鈥 Sheryl Skolnick, an analyst at Mizuho Securities, said in a note. The Minnetonka, Minnesota-based company 鈥渋s insulated in part from the exchange issue because it entered late and in a more limited way than peers, and because it has a more diversified business model. We expect the group to get hit harder.鈥 (Tracer, 11/19)

Currently, UnitedHealth Group has about 550,000 customers through health insurance exchanges in 23 states. When the exchanges were launched in 2014, UnitedHealth Group offered products in only a few of the marketplaces, but grew the business considerably this year. (Snowbeck, 11/19)

"in recent weeks, growth expectations for individual exchange participation have tempered industry wide ... so we are taking this proactive step," UnitedHealth Chief Executive Stephen Hemsley said in a statement on Thursday. ... Other large health insurers including Cigna, Humana, Aetna have said also said that the individual plans they offer could be affected in 2016. (11/19)

In other insurance industry news -

Shares of some high-profile takeover targets are trading at steep discounts to the prices of deals they signed, showing fissures may lurk in the current deal boom. ... Cigna Corp.鈥檚 stock is 22% below the value of Anthem Inc.鈥檚 $48 billion offer, while oil-field-services provider Baker Hughes Inc. trades 17% cheaper than the price of its pending $35 billion sale to Halliburton Co.鈥 ... Meanwhile, there have been signs that regulators take a dim view of some of the big pending deals. They are closely reviewing both Anthem鈥檚 deal for Cigna and the $34 billion proposed tie-up of Aetna Inc. and Humana Inc. Together, the two deals would trim the number of big health insurers from five to three. (Hoffman, 11/18)

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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