Commentary: Are the ACA exchanges unraveling?

Commentary: Are the ACA exchanges unraveling?

By Paul von Ebers  |  February 11, 2016

A slow motion train wreck is underway on the ACA insurance exchanges, but it is a crash that can be avoided if insurers, providers and regulators take decisive action.

WellCare craves M&A opportunities and has money to spend

By Bob Herman  |  February 10, 2016

WellCare executives are getting “formal M&A training” this month and will eventually scour the marketplace for promising Medicaid and Medicare Advantage plans. The insurer has been storing surplus cash and now has $1.25 billion of “dry powder” to spend on transactions.

CMS may overhaul enrollment process, could include questions about sexual orientation

By Virgil Dickson  |  February 08, 2016

As the CMS seeks to simplify the application process for exchange plans and Medicaid, payers want to make it harder for individuals to sign up after open enrollment ends. Meanwhile, advocates and providers want to reduce barriers and have the CMS learn more about who is signing up, including their...

ACA  enrollment pleases HHS, but insurers have some complaints

ACA enrollment pleases HHS, but insurers have some complaints

By Bob Herman  |  February 06, 2016

HHS says that 12.7 million people signed up for 2016 coverage through the insurance exchanges, well within previously stated expectations. Now the Obama administration must ensure that the risk pool evens out so that premiums will stabilize and insurers will remain interested in selling the plans.

Blog: Insurers' moves suggest yearning for old cherry-picking days

By Harris Meyer  |  February 04, 2016

A new report shows that major health insurers are moving away from the Affordable Care Act's reformed insurance market to the days of favoring healthier customers. That could bolster Democratic presidential candidate Bernie Sanders' argument to abolish private insurance.

Insurer Aetna lays out concerns about ACA exchange business

By Associated Press  |  February 01, 2016

Aetna has joined other major health insurers in sounding a warning about the ACA's public insurance exchanges. The nation's third-largest insurer said Monday that it has been struggling with customers who sign up for coverage outside the ACA's annual enrollment window and then use a lot of care.

The health insurance industry's identity crisis

The health insurance industry's identity crisis

By Bob Herman  |  January 30, 2016

Most insurers have embraced the ACA, and it has helped many of them financially through the tacit encouragement of products such as high-deductible plans. But many still puzzle over how to pivot beyond what was long the core of their business: employer-based plans and holding down medical claims.

AHIP starts early with Medicare Advantage political pressure

AHIP starts early with Medicare Advantage political pressure

By Bob Herman  |  January 28, 2016

America's Health Insurance Plans, the primary lobbyist for the health insurance industry, is funding a “seven-figure” ad campaign that targets Medicare Advantage and aims to put pressure on the Obama administration to stabilize funding for the private version of Medicare.

Q&A: Marilyn Tavenner on AHIP's way forward

Q&A: Marilyn Tavenner on AHIP's way forward

By Modern Healthcare  |  January 23, 2016

Former CMS chief Marilyn Tavenner discusses her move to head up America's Health Insurance Plans and the challenges faced by the group's members, which have struggled in the fledgling insurance marketplaces created under the ACA.

Dealmaking keeps up heady pace

By Melanie Evans  |  January 23, 2016

Last year ended as frenzied as it began for healthcare dealmakers. Globally, merger and acquisition activity reached record volume in 2015, and the value of global healthcare deals increased 66% last year to $723.7 billion, according to Dealogic.

CMS bans Cigna from selling new Medicare Advantage plans

By Virgil Dickson  |  January 22, 2016

The CMS has banned Cigna from offering new Medicare Advantage plans after finding issues with the way the insurer handled appeals, grievances and its drug formulary. Investors don't believe the sanctions would affect the insurer's pending deal with Anthem.

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