KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Insurers, Hit Hard By ACA Loses, Eye 2016 Profits As Pivotal To Staying In The Exchanges

Humana is the latest to say it has experienced loses from plans under the health law. “If 2016 is like 2015, we’ll have a real problem, because carriers could just start pulling out,” said one analyst.

The Wall Street Journal: Insurers Under Pressure To Improve Margins On Health Plans
After most health insurers racked up financial losses on Affordable Care Act plans in 2014, many companies’ results for last year worsened, creating heavy pressure to improve performance this year. An analysis of filings by not-for-profit Blue Cross and Blue Shield insurers ... shows the challenge facing the industry .... They paid out more for health care in the first three quarters of 2015 than they took in from premiums on their individual plans. On Wednesday, Humana Inc. became the latest of the big publicly traded companies to flag problems, saying its losses on individual plans deepened last year. (Wilde Mathews, 2/10)

The Wall Street Journal: Humana Profit Falls, But Guidance Comes In Above Views
Humana Inc., which in July agreed to be acquired by rival Aetna Inc., said profit fell 30% in the fourth quarter as it set aside a reserve to account for losses expected on its 2016 Affordable Care Act business, but the firm gave guidance for the year sharply above Wall Street expectations. “Humana faced challenges across a number of fronts in 2015,” said Chief Financial Officer Brian Kane. But he said strength in its clinical model and administrative cost discipline, along with targeted pricing, helped position the company for “meaningful margin improvement” in its core individual Medicare Advantage business for the year. (Steele, 2/10)

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