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Wednesday, Apr 20 2016

Full Issue

UnitedHealth To Exit All But A Few ACA Markets

The insurer's exchange business was relatively small, but the move draws attention to the industry's struggle to adjust to the sicker, more costly pool of customers that have dominated the market under the Affordable Care Act.

The UnitedHealth Group, one of the nation鈥檚 largest health insurers, told investors on Tuesday that it continued to lose hundreds of millions of dollars selling individual policies under the federal health care law. The company said it planned to pull out of a majority of states where it offered coverage and would offer policies on the public exchanges in 鈥渙nly a handful of states鈥 for 2017. (Abelson, 4/19)

After losses on the exchanges, UnitedHealth Group Inc. will pare its presence from 34 states this year to 鈥渙nly a handful鈥 in 2017, said Chief Executive Stephen J. Hemsley during the company鈥檚 first-quarter earnings conference call Tuesday. Mr. Hemsley said that the 鈥渟maller overall market size and shorter-term, higher-risk profile within this market segment continue to suggest we cannot broadly serve it on an effective and sustained basis.鈥 UnitedHealth also steepened its projected loss on the 2016 exchange business to $650 million from around $525 million, amid signs that new enrollees鈥 health status appeared worse. (Wilde Mathews, 4/19)

The company saw particularly strong results with its health service business Optum, which consults with industry players on how to cut costs and better the quality of care. It saw $19.7 billion in revenue during the first quarter as compared to $12.8 billion during that quarter last year. (Jones, 4/19)

UnitedHealth said in the fall it expects to lose more than $500 million this year on plans sold on public exchanges. But those are a small part of UnitedHealth鈥檚 business. And, since the insurer booked most of those expected losses last year, these exits mean that shareholders can cross a worry off their list. No wonder the stock is handily outperforming major indices this year. These days, peace of mind doesn鈥檛 come cheap. The shares trade at 16 times forward earnings; well above historical norms for a health insurer. The dividend yield on the shares lies well below 2%. (Grant, 4/19)

UnitedHealth鈥檚 plan to dramatically curtail involvement in the exchanges would severely limit competition in parts or all of about 10 states 鈥 mostly in the South and Midwest, according to an analysis from the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.) That could mean higher premiums for consumers in states and counties left with only one or two insurers, unless another company enters those markets. Oklahoma and Kansas would be left with only one insurer if UnitedHealthcare pulls out. (Galewitz, 4/19)

UnitedHealth Group Inc's decision to exit most of its Obamacare health insurance exchanges next year means rivals will need to raise prices further to prop up an unprofitable business, healthcare analysts and policy experts said on Tuesday. The largest U.S. health insurer's move would likely reduce consumer choices, particularly in states where UnitedHealth has been one of only a handful of players to offer insurance under President Barack Obama's healthcare law, they said. (Humer, 4/19)

The Obama Administration attempted to downplay any departures from UnitedHealth. "We have full confidence, based on data, that the Marketplaces will continue to thrive for years ahead. The number of issuers per state has grown year-over-year," Health and Human Services spokesman Ben Wakana said in a statement released Monday morning. "The Marketplace should be judged by the choices it offers consumers, not the decisions of any one issuer." (Johnson, 4/19)

The company鈥檚 startling losses cast a spotlight on problems that insurers have been warning about for months: Fewer Americans have signed up for the exchanges than predicted, enrollees have proved to be sicker and more costly than anticipated, and losses are mounting. UnitedHealth鈥檚 exit may be more of a symbolic blow to the law than anything 鈥 the company is still profitable, and its exchange business was relatively small. But it poses a fresh headache for the White House ahead of the fall sign-up period for 2017 health plans, the final enrollment season under the Obama administration. The White House is scrambling to set the insurance marketplaces on firm footing before it leaves office. (Demko, 4/19)

UnitedHealth hiked its 2016 forecast after the nation's largest health insurer topped Wall Street's first-quarter earnings expectations. The Minnetonka, Minnesota, company now expects annual adjusted earnings ranging from $7.75 to $7.95 per share. That's up 15 cents from when it last reaffirmed its outlook in January. (Murphy, 4/19)

UnitedHealthcare, a major health insurer, will no longer sell insurance on the Affordable Care Act marketplace in Texas next year, according to a letter filed with state regulators. (Walters, 4/19)

UnitedHealthcare will stop offering plans through Connecticut鈥檚 health insurance exchange after this year, continuing the company鈥檚 departure from the state-level marketplaces created by the federal health law. (Levin Becker, 4/19)

Thirty of Georgia鈥檚 159 counties will be left with just one insurer in the state insurance exchange when UnitedHealthcare exits the exchange next year, a new study says. Another 47 Georgia counties will go from having three exchange insurers to two, according to the study, released Monday by the Kaiser Family Foundation. (Miller, 4/19)

Minnetonka-based UnitedHealth Group reported a first-quarter net income of $1.6 billion, up 14 percent over last year. Revenue grew 25 percent to $44.5 billion. CEO Stephen Hemsley told investors UnitedHealth is serving more customers than ever before and that customer retention also is at record levels. (Zdechlik, 4/19)

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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