UnitedHealthcare Logo

As I've griped about many times before, it's confusing as hell trying to keep track of a bunch of insurance carriers which have similar names. For instance, in Kansas, they have both Blue Cross Blue Shield of Kansas and Blue Cross Blue Shield of Kansas City...which are apparently considered separate corporations.

Picking on  Kansas again, one of the carriers offering ACA exchange plans is called Sunflower State Health Plan...but if you look it up, you'll see that "Sunflower Health" is actually owned by Centene Corporation. Which also owns "Ambetter Health." Oh, and they also own "Celtic Insurance" as well.

In fact, Centene Corporation has no fewer than 28 other subsidiaries. Now, in some cases these may not be health insurance carriers, and in others they may simply be "product branding" instead of actual corporate subsidiaries, but it's still confusing as hell.

Note: I've been distracted by my county-level COVID19 tracking project for the past couple of weeks, so I'm posting a series of entries on various ACA/healthcare policy developments which I've missed along the way.

Back in 2016, many health insurers which had been losing money hand over fist on the ACA individual market (in spite of many making record profits in other divisions) decided to bail on the ACA market entirely. Of these, the biggest shocks to the system were Aetna, Humana and UnitedHealthcare, each of which pulled out of multiple states, and UHC bailing was the biggest blow of all:

Back in mid-April, I posted the UnitedHealthcare State Dropout Odometer, which tracked exactly which of the 34 states which UnitedHealthcare is currently offering individual market policies in this year they'd drop out of for 2017. Instead of simply stating "we're sticking around in these states and dropping out of the rest", United decided to dole the pain out gradually, with states announcing their departure one by one over several weeks. For quite awhile, I knew that they were sticking around Nevada, New York and Virginia, with another half-dozen states in limbo status.

Today, according to the Chicago Tribune and the Minnesota Star Tribune, it looks like those three are it: They'll still be available in those 3 states, but are pulling out of the other 31 (including California, where they only have around 1,200 current enrollees via the exchange anyway). OK, that sucks, but we kind of knew about this already; it's old news for the most part.

After a couple of quiet weeks, I have to dust off the UnitedHealthcare Dropout Odometer again. According to Katie Jennings of Politico...

UnitedHealth Group is pulling out of New Jersey’s Obamacare marketplace in 2017.

The company’s subsidiary, Oxford Health Plans, will stop offering individual plans on the state’s federally facilitated health insurance marketplace, according to a letter from the state Department of Banking and Insurance.

The letter was obtained by POLITICO through an Open Public Records Act request and the company later confirmed it will not offer exchange plans next year.

“Individuals impacted by these decisions will continue to have access to their current health benefits until the end of 2016, when they will need to pick new plans for 2017. Our small and large group business, Medicare and Medicaid businesses will not be impacted by this decision,” the company said in an emailed statement.

Last month there was much handwringing over the news that UnitedHealthcare has decided to take their ball and go home, pulling out of the individual market in more than 2 dozen states. Shortly after that came the news that Humana is also tidying up their books by dropping individual plans in at least 5 states.

However, capitalism abhors a vacuum. In Iowa, even as UnitedHealthcare is leaving, Wellmark Blue Cross Blue Shield is stepping in to fill the gap there...and today brings some welcome news about another major carrier, Aetna:

Health Insurer Aetna Inc on Wednesday said it plans to continue its Obamacare health insurance business next year in the 15 states where it now participates, and may expand to a few additional states.

UnitedHealthcare is operating on the ACA exchanges in 34 states this year. I assumed that they'd announce which states they were staying in or dropping out of all at once during yesterday's quarterly earnings conference call, but apparently not. Instead, the status of each state has been dribbling out one by one over the past week or two.

Zachery Tracer is doing a great job of keeping track over at Bloomberg News.

As of this writing, Tracer has the drop-out list up to 18 22 23 24 25 26 27 28 states, including:

UPDATE: Zachery Tracer of Bloomberg News and Phil Galetitz of Kaiser Health News have confirmed that UnitedHealthcare will stay in Virginia and Nevada next year, but they won't stay around in Connecticut. More details as they come in....

Update 4:10pm: According to Zachery Tracer, UnitedHealthcare to pull out of Texas, Pennsylvania, North Carolina, Tennessee and Missouri as well.

Update 7:05pm: OK, Tracer has updated his list of the states United won't be in next year:

Over the past week or so, UnitedHealthcare started making good on their threat last fall to drop out of the ACA exchanges in at least some of the 33 states that they offer individual market policies in. On April 8th they said they were pulling up stakes in Arkansas and Georgia (although they're keeping a small presence in Atlanta via their experimental "Harken Health" division). Then, last Friday, they said they were dropping off the Michigan exchange as well...and just today, Adam Cancryn noted that they're pulling the plug on Oklahoma, while Zachary Tracer says they're pulling out of Louisiana. Ugh.

Back in November, one of the big ACA stories was UnitedHealthcare, shortly after releasing third quarter financial results which made it sound like all was well with their ACA exchange business, dropping a bombshell only a month later stating that they were losing hundreds of millions of dollars on the exchanges and were very likely to drop out next year.

This caused all sorts of shockwaves among the insurance industry, and of course gave ACA critics more ammunition with which to attack Obamacare as a whole, calling it evidence of the system being a failure, etc etc...even though several other major insurance carriers on the exchanges didn't seem to be complaining (or at least weren't making it out to be nearly as dire of a situation as UHC).

At the end of December, UnitedHealthcare (along with some other carriers) complained about CMS publicly posting their proposed rate increases:

Hat tip to someone named "Chuck" (no last name or organization given) for the tip.

Yet Another Post® about UnitedHealthcare, I'm afraid. Healthcare pundits/reporters have found last week's United announcement extremely oddly-timed, especially given that they were giving a very positive outlook for the ACA exchanges just a month earlier.

In short: UHC sat out the ACA exchanges in 2014, dove into half the states head first for 2015, expanded into another 11 states for 2016...but then suddenly announced that they "may" drop out of the exchanges completely in 2017? Furthermore, they made this announcement a month after painting a glowing outlook in their official quarterly report and did so in the middle of the 2016 open enrollment period? Something doesn't sound right here.

Well, today I've learned another tidbit which seems odd to me, although it's possible that there's nothing amiss here: