UnitedHealthcare, in an effort to cut its losses in the individual market, will only compete in three states' Affordable Care Act marketplaces in 2017: New York, Nevada and Virginia, according to the Minneapolis Star Tribune.
In April, CEO Stephen Hemsley said United would remain in only "a handful" of states' ACA exchanges due to small market size and a high-risk pool of enrollees. Hemsley's remarks that United can't sustain a marketplace that doesn't seem to be sustaining itself drew a rebuke from Covered California Executive Director Peter Lee, who has said the ACA is not the problem--United's mishandling of rates and networks is.
That brings the grand total to 31 states that United is exiting due to financial losses in ACA marketplaces. The news of one payer leaving so many state exchanges isn't earth-shattering, according to healthcare consultant Robert Laszewski, but he argues it is indicative of the ACA's shortcomings such as high premiums, financial setbacks for payers and coverage opt-outs.
However, Cynthia Cox, a researcher at the Kaiser Family Foundation, tells the Star Tribune that United's decision to exit almost all state exchanges isn't a reflection of a larger issue with the marketplace, because other payers aren't following in United's footsteps.
As FierceHealthPayer previously reported, United's independent subsidiary Harken Health will still offer plans in the Illinois and Georgia exchanges next year. Harken takes a wellness-focused approach by offering free primary care services at its affiliated clinics, which it hopes will be a successful business model in the individual market.
To learn more:
- read the Star Tribune article