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You are here: Home / Anderson On Health Insurance / Aetna and cynicism confirmed

Aetna and cynicism confirmed

by David Anderson|  January 23, 201712:51 pm| 31 Comments

This post is in: Anderson On Health Insurance, C.R.E.A.M., Free Markets Solve Everything

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The anti-trust case where the government has been seeking to block the Aetna-Humana from merging has a ruling. The District Court judge has sided with the FTC and blocked the merger. I would be shocked if the ruling is not appealed.

There is a bit in here that made me smile as it gives some context to some of my more cynical writing over the summer. Aetna was profitable on the QHP market in Pennsylvania. However it pulled out of the entire state despite making a good deal of money.

Aetna was profitable in 2015 in the individual market in Pennsylvania. It is projecting to be profitable in 2017. The filing memo was drafted in late May and submitted to the Pennsylvania regulators in early June. Conditions have not changed enough to make Pennsylvania a money loser in under two months.

My wee bit of cynicism bears fruit. Aetna is trying to logroll an anti-competetive merger with on-Exchange political consequences.

The judge seems to be a cynical bastard as well:

Aetna ditched ACA exchanges to make itself look smaller and help its proposed Humana merger avoid antitrust scrutiny, judge rules pic.twitter.com/NzBbfcm4KT

— Jeff Overley (@JeffOverley) January 23, 2017

I’ll have more on this including a policy perspective when I have time to write, but cynicism was completely justified.

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Reader Interactions

31Comments

  1. 1.

    The Moar You Know

    January 23, 2017 at 12:53 pm

    I claim cynicism second to none but to dump profitable business to try to fool a judge into rubberstamping a merger is well beyond my abilities.

    Well done, Aetna, well done. Pls to die in a fire.

  2. 2.

    dr. bloor

    January 23, 2017 at 1:00 pm

    @The Moar You Know: That’s no way to talk to your healthcare “partner,” Moar.

  3. 3.

    Jeffro

    January 23, 2017 at 1:00 pm

    Is it wrong to send the judge flowers?

  4. 4.

    Steve in the ATL

    January 23, 2017 at 1:00 pm

    Good post, but Richard Mayhew was much sharper on the issues

  5. 5.

    D58826

    January 23, 2017 at 1:02 pm

    OT but looks like the worlds two biggest dictators are super happy with the election results. Valid got his puppet. And by withdrawing from TPP the puppet just gave China the keys to the western Pacific. Well played Das Fuhrer.

    And on a related note Bernie is so happy about the demise of TPP he has announced that he will work with Das Fuhrer on trade issues.

    And Susan Sarandon has decided that maybe electing Trump wasn’t such a good idea after all as she praises the women who marched on Sat.

  6. 6.

    The Moar You Know

    January 23, 2017 at 1:09 pm

    And on a related note Bernie is so happy about the demise of TPP he has announced that he will work with Das Fuhrer on trade issues.

    @D58826: I’m just glad the two divisions of PutinCorp have managed to come together and work towards the common goal.

  7. 7.

    ? Martin

    January 23, 2017 at 1:10 pm

    @D58826:

    And by withdrawing from TPP the puppet just gave China the keys to the western Pacific.

    Probably more than just the western Pacific, actually. If the US is going to go America First, why would any US ally stick with us? China has already displaced the US for foreign development in many parts of the world, and I don’t see why they wouldn’t follow by being a better patron state than the US. And Germany will almost certainly take the role of moral compass from us.

    I think Americans forget that we’re only 4% of the world population. We should be very much a minority player, but found ourselves a majority player due to circumstance. I don’t think most Americans realize how much we should need to work to retain that global leadership position, and how much we stand to lose by having it taken from us.

  8. 8.

    Mike J

    January 23, 2017 at 1:15 pm

    @? Martin: Taken from us? We’re giving it away.

  9. 9.

    Calouste

    January 23, 2017 at 1:16 pm

    @D58826: Not going to pay attention to Sarandon unless she apologizes for saying that Clinton would be worse than the shitgibbon with a statement that includes the phrase “I was a entitled braindead fucking idiot”.

  10. 10.

    Skepticat

    January 23, 2017 at 1:16 pm

    “… but cynicism was completely justified.”

    YA THINK?

  11. 11.

    Calouste

    January 23, 2017 at 1:18 pm

    @ Martin: China is going to take over anyway. They have 3 times as many people as the US, and are now at about 60% of its GDP. There is massive room there to grow still. Japan is only at about 25% of the US GDP, Russia at 7%.

  12. 12.

    ? Martin

    January 23, 2017 at 1:20 pm

    @Mike J: They’re always trying to take it. But yeah, totally our fault for not fighting to keep it.

  13. 13.

    JPL

    January 23, 2017 at 1:21 pm

    @Steve in the ATL: lol

  14. 14.

    rikyrah

    January 23, 2017 at 1:27 pm

    How Republicans Will Lower Health Insurance Premiums: A Return to Junk Plans
    by Nancy LeTourneau
    January 23, 2017 12:16 PM

    Over the years Republicans have told a lot of lies about Obamacare. Leading the way has been their claim that the law is a government takeover of health care. The truth is that, whether you get insurance from your employer or via the Obamacare exchanges, you have health insurance provided by private insurance companies. The exceptions are, of course, Medicare and Medicaid—both of which were implemented long before Obamacare passed.

    But we all know that Republicans hate any form of government regulation—and Obamacare heavily regulated the insurance market. Included in the law are:

    A ban on denial of coverage for pre-existing conditions,
    A requirement to cover children until the age of 26,
    A requirement that only 15% of premiums (20% in the individual/small group market) can go to overhead/profit (medical loss ratio, or MLR),
    A list of 10 essential benefits insurers must cover, and
    A ban on annual and lifetime caps on what insurers will pay out.
    We’ve heard a lot about the first two and many Republicans are promising to keep them in place when/if they repeal and replace Obamacare. While eliminating the MLR would likely cause premiums to rise, getting rid of the last two could reduce them significantly. Doing so would bring back what Consumer Reports once called “junk health insurance.”

    The most common form of these junk plans prior to the passage of Obamacare was something called “mini-med health plans.” They tended to cover the first $2,000 to $7,000 of health expenses, with the remainder coming out of the pocket of those insured. That works as long as you stay health and free of accidents. But take a look at what happened to one woman who had such coverage:

    Judith Goss, 48, of Macomb, Mich., believed that the Cigna plan she obtained through her job at the Talbots retail chain was “some type of insurance that would cover something.” When the store she worked at closed in January 2011, she even paid $65 a month to keep the coverage through COBRA.

    “I was aware that it wasn’t a great plan, but I wasn’t concerned because I wasn’t sick,” she says. But in July 2011 she was diagnosed with breast cancer, at which point the policy’s annual limits of $1,000 a year for outpatient treatment and $2,000 for hospitalization became a huge problem. Facing a $30,000 hospital bill, she delayed treatment. “Finally my surgeon said, ‘Judy, you can’t wait anymore.’ While I was waiting my tumor became larger. It was 3 centimeters when they found it and 9 centimeters when they took it out

    .”

    After paying in $65/month, Judith got payment for $3,000 of her expenses to treat breast cancer and then was on her own. That’s why Consumer Reports actually says that they are worse than having no insurance…you pay in, but get almost nothing back when you need it most.

    Kim Soffen and Denise Lu report that all of the Republican alternatives to Obamacare eliminate the requirement for including 10 essential benefits. Orrin Hatch’s replacement plan allows insurers to cap annual payments and Ryan’s Better Way plan doesn’t mention caps (i.e., they would return).

    These are important elements to keep in mind. Allowing the return of junk health insurance would mean that Republicans can claim to make premiums more affordable. But for people in Judith’s situation, they will assume they are covered when they’re not.

  15. 15.

    KG

    January 23, 2017 at 1:27 pm

    Speaking on my limited practice in federal courts:

    Federal judges, as a rule, don’t take kindly to bullshit.

  16. 16.

    Another Scott

    January 23, 2017 at 1:28 pm

    @D58826: Oh no, you said the Secret Word.

    :-(

    Cheers,
    Scott.

  17. 17.

    Corner Stone

    January 23, 2017 at 1:30 pm

    @Steve in the ATL:

    Good post, but Richard Mayhew was much sharper on the issues

    Eh, he was pretty much an obdurate hack on healthcare and health insurance matters. His writing really only peaked when discussing randy referees and oversexed college age soccer playing females. I say we give this new guy a chance.

  18. 18.

    Roger Moore

    January 23, 2017 at 1:31 pm

    @rikyrah:
    Remember, though, that the CBO said they were going to include insurance adequacy as part of their scoring of how many people are likely to be covered. If the Republicans gut the benefits required for a plan to qualify, it’s going to hurt their official coverage numbers because many of the plans people will buy won’t qualify as real health coverage.

  19. 19.

    schrodingers_cat

    January 23, 2017 at 1:32 pm

    @Corner Stone: But only if he has Tunch sized kittehs, whose photos he shares with us on a regular basis.

  20. 20.

    Doug R

    January 23, 2017 at 1:37 pm

    @? Martin: Trudeau shuffled his cabinet in anticipation of trump’s shenanigans.
    Included was a new business friendly ambassador to China.
    Talk around canuckistan is a pivot to more Asian trade if Hair Fuher closes down trade.

  21. 21.

    Corner Stone

    January 23, 2017 at 1:43 pm

    @schrodingers_cat: Good God. “Kittehs”…plural? The poor guy has kids to feed!

  22. 22.

    Yarrow

    January 23, 2017 at 1:45 pm

    @D58826:

    And Susan Sarandon has decided that maybe electing Trump wasn’t such a good idea after all as she praises the women who marched on Sat.

    She should be shunned.

  23. 23.

    Corner Stone

    January 23, 2017 at 1:45 pm

    The Spicer Must Flow!

  24. 24.

    Villago Delenda Est

    January 23, 2017 at 2:18 pm

    @Steve in the ATL: This David Anderson guy plagiarized his cynicism from Richard Mayhew!

  25. 25.

    Villago Delenda Est

    January 23, 2017 at 2:18 pm

    @Corner Stone: The Sphincter must flow!

  26. 26.

    Villago Delenda Est

    January 23, 2017 at 2:20 pm

    @The Moar You Know: Bernie is pissing me off more and more. He has all the knowledge of the details that Donald has.

    Fuck him, and fuck his idiot Berniebro followers.

  27. 27.

    Mnemosyne

    January 23, 2017 at 2:30 pm

    @D58826:

    Sanders and his Bros are pleased to call themselves “pacifists,” but they’re actually isolationists. Pacifists are happy to interact with the world in a peaceful way, while isolationists aren’t.

    In case it’s not clear, I’m fucking sick of isolationists hijacking the pacifist movement.

  28. 28.

    Jacel

    January 23, 2017 at 2:45 pm

    @? Martin: So if the US has only 4% of the world’s population, then relative to the US, California has three times that share of its population (12%).

  29. 29.

    Roger Moore

    January 23, 2017 at 4:32 pm

    @Corner Stone:
    The man has less flow than Vanilla Ice.

  30. 30.

    schrodingers_cat

    January 23, 2017 at 5:32 pm

    @Corner Stone: You need at least two, they keep each other company when you are busy.

  31. 31.

    Buskertype

    January 23, 2017 at 6:41 pm

    I hope you’re going to give us your appraisal of the bill Sen. Collins et al put forward as an ACA replacement.

    I’ve been on the phone with a nice young woman from Capito’s office about once a week since December, pleading with her to tell me what her plan is… so now that it’s out I want to call in with an intelligent review. So far I have a ton of questions, but it looks like not the worst possible plan, although substantially less good than Obamacare.

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