Humana latest to threaten Obamacare exchange exit in 2017

Humana offered hints that it will be the next insurer to depart from Affordable Care Act marketplaces in its first quarter earnings report.

The company reported May 4 its profit decreased 46 percent year-over-year, owing to costs related to its pending acquisition by Aetna and a 21 percent drop in the number of customers who bought plans from the exchanges. While the report doesn’t detail which states Humana might leave, it does promise some sort of changes are imminent.

“Humana is in the process of finalizing plans for its ACA-compliant individual commercial medical market offerings in 2017,” the report said. “Humana anticipates proposing a number of changes to retain a viable product for individual consumers, where feasible, and address persistent risk selection challenges. Such changes may include certain statewide market and product exits both on and off exchange, service area reductions and pricing commensurate with anticipated levels of risk by state.”

Humana would be the second major health insurer to leave the exchanges, following the April announcement by the nation’s largest insurer, UnitedHealth, that it would be scaling back to a “handful” of states after reporting a $650 million loss on its marketplace business in 2015. Humana didn’t offer a prediction on whether it will lose money this year on the exchange plans it offers in 15 states.

Other companies have announced they’ll continue offering coverage on the exchanges in 2017, including Humana’s buyer, Aetna.

“If we were to go out and buy those members, it would cost us $1.2 billion to buy them. ... So in the broad scheme of things, we are well, well below any of those numbers in terms of the losses in the first two years of the program," said Aetna CEO Mark Bertolini in April, according to the Hartford Courant. "So we see this as a good investment.”

Other Humana competitors have indicated they may expand their exchange business, Forbes reports, including Anthem and Centene. 

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John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

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