Posts Tagged ‘Aetna’

If Aetna Leaves the Exchanges, Others Likely to Follow

Thursday, January 23rd, 2014

With all of the ruckus over the Affordable Care Act, there is one aspect that we haven’t considered yet in this blog.  Health insurance companies might start backing out of the exchanges if things don’t go as planned with enrollment.  So far, not enough young and healthy people have purchased insurance through the exchanges.  This puts the entire plan out of balance because young people help to keep the costs down for everyone involved, including the insurance companies.  According to CNBC’s Matthew Belvedere, “Aetna could be forced out of Obamacare: CEO.”  Aetna’s CEO, Mark Bertolini, worries that the age of enrollment and Medicare changes could force his company out of the health insurance exchanges.  They have to publish their health insurance rates in the exchange for 2015 by May of this year.  As of now, they don’t have enough information to decide whether they will have double digit gains, smaller gains, or have to leave the program altogether.

According to Aetna’s CEO, the majority of people who have bought health insurance in an exchange already had individual health insurance.  They just switched to an exchange to save money because of the available federal subsidies.  Right now, 11% of the people buying in exchanges were fully uninsured before the Affordable Care Act.  That statistic isn’t promising to support the claims that this act would help insure nearly all Americans in an affordable way.  Mr. Bertolini says that the exchanges need more choices in them.  More insurance companies need to offer plans in the exchanges in order for them to actually function like the marketplace they were supposed to.  This will bring more Americans into the exchanges to search for health insurance.  This could also bring more younger, healthier people into the exchanges.  These young Americans help keep rates down for everyone.  Plans from the Afforable Care Act only make up 3% of Aetna’s revenue, so they aren’t concerned about it making or breaking them.  It seems to me that the process is more of a headache to Aetna as it stands now.  Aetna’s CEO forecasts a large number of people using exchanges over the next 6 years, but says the majority of those will be in private exchanges rather than public.


Access Health CT to Open Six Storefronts in Connecticut

Monday, June 17th, 2013

Connecticut is the latest state opening brick and mortar health insurance exchange locations to help match the uninsured with health plans.  In The Bristol Press, Scott Whipple detailed the new locations in his article “Health insurance exchange coming soon to match uninsured with health care plan.”  Originally, Access Health CT, the state insurance exchange, thought that they would be opening seven locations.  After working on their plans for two years, it looks like they will open six locations.  New Britain’s storefront will be in addition to the other five locations in Bridgeport, Hartford, New Haven, Stamford, and Waterbury.  They have yet to finalize the New Britain location, but stress that it will both have plenty of parking and be located very near a CTfastrak terminal.

New Britain’s location was chosen to help match some of the 334,000 uninsured Connecticut residents with affordable health insurance plans for a few reasons.  It is a poorer city, very densely populated, and has a high number of residents who don’t currently have health insurance.  The location should be open on or before October 1 of this year.  Each Access Health location will have brokers on site as well as people there with specific knowledge of the Affordable Care Act and how it will affect uninsured individuals.  They are structuring their storefronts in the way of Apple in order to mimic their way of making it easy to buy a more sophisticated product in a clean, well lit and high-functioning space.

Access Health CT’s chief marketing officer said that the most difficult part of this planning has been that the uninsured have no knowledge of the insurance plans available to them.  One local Connecticut health insurance broker doesn’t think that the state is doing anything different and points out that there are already insurance storefronts where the uninsured could have gone to look for options.  But I do think it will be different for the government run program because of the changes with the Affordable Care Act.  Access Health’s CMO made a career change after the passage of this act to see what will come of the sweeping changes, after working for big insurance names like Aetna and Wellpoint.  While he admits that he doesn’t know it will all work out, he is hopeful that the hundreds of thousands of uninsured residents in Connecticut will be able to find affordable health insurance.

Here’s to Hoping Health Care Costs Don’t Soar

Wednesday, March 27th, 2013

There were many purposes for the Affordable Care Act, not the least of which was to lower health care costs for Americans.  By creating insurance pools to increase competition among health insurers, the idea was that the cost of health care services and premiums would decrease.  While that is still President Obama’s hope, The Society of Actuaries just released a report saying that many consumers may see just the opposite effect.  The Motley Fool’s Sean Williams asks “Is Obamacare About to Skyrocket Your Health Care Costs?”

Some of the other changes being made in addition to creating insurance pools are banning insurers from denying people coverage for pre-existing conditions, mandating individuals to carry health insurance, and  requiring insurance companies to spend 80% or more of the premiums they collect on actual care.  The law also qualifies more patients for Medicaid and creates a medical device excise tax of 2.3% from medical device makers’ revenue.  That last change will help to pay for the expansion of the government sponsored Medicaid program.

So, all of these changes sound great right?  The problem that The Society of Actuaries found is an estimated 32% increase in the cost of underlying claims by the year 2017.  This is an estimated cost for non-group members, or those who don’t have insurance through their employer.  These prices can and should go down with the competition from the created pools, but some states may still see increases.  Ohio and Wisconsin are forecasted to see the cost of their claims go up by 80%.

32 million people who were uninsured will now be able to afford and carry health insurance because of the Affordable Care Act.  In addition to that, many consumers who had very basic health coverage will be able to get better insurance.  But there are some companies and individuals negatively affected by this and making changes because of it.  Stryker, a medical device manufacturer, cut its workforce by 5% because of the new tax imposed upon them.  Aetna increased some premiums by 21% in anticipation of the impending caps on pricing from the law.  Many other companies, including Papa John’s pizza, have complained to lawmakers about the increase in costs to them because of the law.  Is there really any sweeping change that could positively effect everyone involved?

Aetna Insurance Paying for Obesity Pills

Wednesday, November 21st, 2012

One decision made by one health insurance company can really change the ways of the whole industry.  Aetna has made the decision to cover the cost of weight loss drugs for some of its patients.  This not only helps these patients, but the drug makers have seen an increase in stock prices because of this decision by Aetna.  They will be selling more weight loss drugs because of Aetna’s patients, but it also is likely that other health insurers will follow Aetna’s lead and cover the drugs for their patients as well.  This information comes from The Associated Press article “Weight loss drugmakers rise on Aetna Policy Update.”

Vivus Inc.’s Qsymia and Arena Pharmaceuticals Inc.’s Bleviq will now be covered by Aetna for patients who have a medical necessity.  Aetna already covers Pfizer Inc.’s Didrex, GlaxoSmithKline plc’s Alli, and Roche’s Xenical.  Aetna has the third largest enrollment of all health insurance companies in the United States.  With 35% of the population being obese, Aetna has deemed this medical problem serious enough to cover drugs to help take care of it.  Untreated, obesity leads to a host of other medical conditions that may cost insurers much more than these pills.

It’s not yet clear how many more people will be able to receive these drugs with Aetna’s policy update.  Compare other health plans and it’s likely that the largest insurers will follow Aetna’s lead in covering these weight loss drugs.  The FDA has been more willing to approve new weight loss drugs in the last year.  A new drug is expected to be sent for approval next year.  With the news of Aetna’s policy change, Vivus’ shares increased 13% and Arena Pharmaceuticals’ went up by 3.4%.  Orexigen Therapeuticals Inc., who is developing obesity drug Contrave, saw a 6.9% increase in their share price.  Maybe these obesity drugs can help stop the increasing rate of obesity in the United States.