Health Insurer’s to Leave Areas Over Lack of Profits

Health Insurer's to Leave Areas Over Lack of Profits

By Margaret Flowers

When the Affordable Care Act was passed, there was a lot of media attention given to the provision that required health insurer’s to offer health plans to all enrollees regardless of whether or not they had pre-existing health conditions. This was hailed as a huge victory, but those who had witnessed the facility of health insurers to skirt regulations knew they would find a way out of this too.

True to form, health insurers created “ultra narrow” networks which excluded 70% or more of local health facilities, often including major medical centers where people who have serious illnesses need to go for care. When patients go out of network for care, it is not covered by insurance.

Another provision in the ACA gave insurers another out. It was the provision that said while they couldn’t drop people on the basis of pre-existing conditions, they could drop out of geographic areas. And that’s what health insurers have been doing. They look at the numbers and when a particular area is not bringing in enough profit, they leave it.

Politico reports today that Humana is planning to pull out of all of the health insurance exchanges next year and Aetna is considering pulling out.

“Obamacare is in a ‘death spiral,'” the influential CEO of Aetna, Mark Bertolini, declared Wednesday morning.

Bertolini’s doomsday prophesy: More insurers will pull out of the government-run marketplaces in the coming weeks and many areas will have no insurers to provide Affordable Care Act coverage in 2018.

United Healthcare, the largest health insurer in the United States, already pulled out of most exchanges this year.

Blue Cross Blue Shield plans to stay in the exchanges where, without competition, it will be able to demand higher premiums. For example, in Alabama where BCBS is the only insurer on the exchange, they planned a 39% increase in premiums this year on top of a 28% increase in premiums the year before.

Threatening to pull out of exchanges gives insurers leverage to force the government to provide more subsidies and reinsurance to cover the costs of paying for health care. The purpose of government subsidies is to protect health insurer’s profits.

It’s time for us to end this form of abuse and extortion by private health insurance companies. They function to create profit for themselves and their investors by raising premiums and out-of-pocket costs and restricting and denying coverage for care.

The best way to create a healthcare system in the United States that has health, not profit, as the bottom line is National Improved Medicare for All

Call your Representative and urge them to co-sponsor HR 676: the Expanded and Improved Medicare Act. The Capitol switchboard is 202 224 3121.

Call Senator Sanders and urge him to introduce a senate companion bill to HR 676. His office number is 202 224 5141.

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