Now making money on Obamacare, Humana still plans to quit exchanges
Louisville-based Humana isn’t budging from its promise to stop selling individual plans in the Obamacare health insurance exchanges -- once and for all – in 2018. There’s only one problem: Humana is finally making money on the plans.
LOUISVILLE, Ky. (WDRB) -- Louisville-based Humana isn’t budging from its promise to stop selling individual plans in the Obamacare health insurance exchanges -- once and for all – in 2018.
There’s only one problem: After losing hundreds of millions of dollars in the business during the first three years of the Affordable Care Act, Humana is unexpectedly making money on the exchange plans this year, company reports show.
In February, when Humana announced it would completely withdraw from the Obamacare exchanges, the company predicted it would lose $45 million on the plans in 2017, its final year in the business.
Humana said it would abandon the exchanges on the same day that the company formally withdrew from its planned merger with rival Aetna, which fell apart due to opposition from the Obama administration’s Justice Department.
But Humana now expects to earn $150 million in pretax income in 2017 from its individual business, which primarily includes Obamacare exchange plans, chief financial officer Brian Kane told investors on the company’s quarterly conference call last week.
The turnaround comes after the company shrank its individual business to a small fraction of previous years. Humana now covers only 142,800 people in individual plans as of Sept. 30, down from 726,200 at the same time last year.
The company shed unprofitable markets, raised premiums on remaining plans and pared back its presence to 11 states, down from 15 last year.
Despite the turnaround, Humana executives have shown no indication they’ve reconsidered exiting the business starting Jan. 1.
“You won’t see us go (back) in the exchanges,” Humana CEO Bruce Broussard told investors at a conference in March. “… Even if they were to change it to be very viable, we wouldn’t be back in.”
In its reports to investors, Humana has said it made a number of changes since it began selling exchange plans in 2014 in hopes the business “would stabilize to the point where we could continue to participate in the program.”
Now, even as the business has turned profitable, the company continues to repeat language in its reports about foreseeing an “unbalanced risk pool” in the exchanges, meaning not enough younger, healthier people in the market to balance older and sicker people who use more health care.
Humana spokesman Tom Noland declined to comment for this story.
The turnaround also hasn’t been of interest to Wall Street analysts who follow the company, as the individual business constitutes a negligible 2 percent of Humana’s total premiums this year.
Humana’s primary business is Medicare Advantage, the privately managed version of the government’s health insurance program for seniors.
Humana is hardly alone in jettisoning the Obamacare business, as competitors Anthem, Aetna and United HealthCare have also announced partial or complete withdrawals from the exchanges.
Besides the structural problems with the exchange markets, there’s uncertainty about a number of federal subsidies that were supposed to cushion insurers’ bottom lines.
Earlier this month, Humana sued the federal government in the U.S. Court of Federal Claims, saying the government owes the company $611 million in “risk corridor” payments that were promised to offset unexpectedly high costs the company incurred with exchange plans from 2014 to 2016.
Humana wrote off the “risk corridor” payments last year after it became clear that the government wouldn’t pay up. But even before the write-off, the company lost $291 million on individual plans last year.
Larry Levitt, a health reform expert and senior vice president at the Kaiser Family Foundation, said Humana’s turnaround with Obamacare plans this year mirrors the industry.
“In the first few years of the Affordable Care Act, most insurers were losing money in the exchanges, but the picture changed dramatically in 2017, driven in large part by big premium increases,” Levitt said in an interview.
Still, he said, some insurers have concluded the business is “just too a risky a proposition” given uncertainty about government support for the exchanges.
Last month, the Trump administration said it would stop paying billions of dollars in cost-sharing subsidies for the plans, and the tax bill moving through the Republican-controlled Senate would repeal the Obamacare mandate that most Americans obtain health insurance or pay a penalty.
“I think it is a different calculation for insures that really placed a big bet on this market and for whom it was central to their long-term strategy,” Levitt said. “For the big national insurers like Humana, they’re making the vast majority of their money elsewhere.”