top of page
  • Andy Adams

United Healthcare "might" leave Obamacare Exchanges . . . SHOCKING? Really?

In the Pixar/Disney movie Finding Nemo, a major plot device is the extremely short-term memory of a fish named Dory (indeed, it looks like the sequel, Finding Dory will almost entirely revolve around this faspect of Dory's personality). It is often hilarious that Dory can't remember something she just learned or was just told. However, it is mostly maddening and frustrating to the characters in the movie, Marlin in particular who is called upon to constantly remind Dory what she knew.

I feel Marlin's pain.

How long will media outlets, experts, "administration officials" or health insurance insiders continue to be "shocked" or "surprised" by the completely predictable consequences of the Affordable Care Act? Dory has an excuse. She's a fish. What is United Healthcare's excuse? From Business Insurance:

[UHC's]Mr. Hemsley said it was not yet known if the exchange problems reflected a structural issue with the exchanges or UnitedHealth issues. The company tried to keep costs down by selling plans with small doctor networks, and priced competitively, he said. It also signed up members with better health than the overall exchange population, but it still lost money, he said.

Under the law, insurers cannot refuse coverage to anyone, and many insurers including Aetna and Anthem have said some members are using medical services heavily, contributing to losses. Members enroll starting in November, but can also pick up coverage during the year based on life changes, like losing a job, and UnitedHealth said those members were the most costly.

Mr. Hemsley said the company had formed its view of the issues based on its own business, but indications were that other insurers in the marketplace were seeing similar dynamics. He told investors that in order to stabilize, the market needs a bigger, more stable pool of enrollees.

"Similar dynamics" like the fact these company are not selling insurance anymore? When you cannot refuse coverage to anyone regardless of their medical condition, you are no longer in the insurance business. You are in a different line of business, something more akin to charity. If I can get you to pay thousands for something I am only paying hundreds for, you are going to lose. The volume of the business will not matter.

So, where are the stories about the predictiable consquences of all this? Where are the stories and interviews with the people that predicted this is precisely what would happen? To be sure, if the health insurance companies had invaded Iraq, we would be hearing from those people 24/7.

The only predictions that matter now are those about what the individual and small group marketplace is going to look like after this train wreck has come to a stop. The most popular take is that the government will be forced to become the single-payor (which was also predicted by all those lunatics and kooks who believe in conspiracy theories). But, that is only going to happen if the government is governed by people interested in preserving Obamacare. That is still an open question.

5 views0 comments
bottom of page