Humana, Inc. announced Tuesday that it would no longer offer individual marketplace health coverage in 2018 after a federal court in January upheld a Justice Department request to block its planned merger with Aetna, Inc.
The move further weakens the stability of the individual insurance market which has been roiled by uncertainty over the proposed repeal of the Affordable Care Act by the GOP-led Congress and the Trump administration.
In a statement, House Democratic Whip Steny H. Hoyer called Humana’s announcement "alarming" and blamed the move on GOP efforts to repeal the health law.
"By continuing to pursue a repeal of the Affordable Care Act – without a real plan to replace it – Republicans are effectively forcing insurers to exit the marketplaces, a trend that will continue unless their rhetoric and policies change," Hoyer wrote.
But a statement by House Energy and Commerce Committee Chairman Greg Walden, R-OR, said Humana’s move "reflects the realities of a failing law."
“Humana isn’t the first insurer to flee Obamacare, and unfortunately, they probably won’t be the last…Patients and families across the country are seeing fewer choices and facing higher costs," Walden’s statement said.
Obamacare continues to fail. Humana to pull out in 2018. Will repeal, replace & save healthcare for ALL Americans. https://t.co/glWEQ0lNR4
Last month, a federal judge blocked the merger of Aetna and Humana, siding with the Justice Department, which found the $37 billion deal would limit competition and increase premiums for plan members.
In a statement, Humana said it will continue to provide coverage through 2017 and “remains committed to serving its current members across 11 states” where it provides individual coverage mainly through the federal marketplace at HealthCare.gov.
The Louisville-based carrier said their decision to leave the market next year was in response to 2017 marketplace enrollment data that shows “further signs of an unbalanced risk pool,” in which more younger, healthier enrollees are needed to offset the higher cost of sicker, older plan members.
“Humana has worked over the past several years to address market and programmatic challenges in order to keep coverage options available wherever it could offer a viable product,” the statement read. “This has included pursuing business changes, such as modifying networks, restructuring product offerings, reducing the company’s geographic footprint and increasing premiums. All of these actions were taken with the expectation that the company’s individual commercial business would stabilize to the point where the company could continue to participate in the program.”
But that hasn’t been the case. Marketplace health insurers are facing turbulent times as they try to operate in the age of Obamacare uncertainty.
Lower enrollment and higher-than-expected medical costs led many to leave the marketplace in the last year and those that stayed hiked premiums significantly in 2017.
To continue beyond this year, insurers want to stabilize the individual insurance market through rule changes that will help attract healthier people into coverage.
“The healthcare industry is in a dynamic state, and the public is looking to companies like Humana to improve the cost of care and the consumer experience,” said a statement from Bruce D. Broussard, Humana’s President and Chief Executive Officer. “As an independent company, we will continue to innovate and sharpen our focus on the local healthcare experience of all our members, especially seniors living with chronic conditions.”
Tony Pugh: 202-383-6013, @TonyPughDC
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