Aetna, led by Mark Bertolini, No. 4, on this year's list, is trying to merge with Humana in a $37 billion deal. Meanwhile, Anthem, led by Joseph Swedish, No. 12, has agreed to merge with Cigna Corp., headed by David Cordani, No. 57, in a $53 billion deal. Final rulings in the challenges to the transactions aren't expected until early next year. This is Swedish's 11th time on the list, which includes his tenure as CEO of Trinity Health before taking the helm at Anthem.
Also cracking this year's top 10 is Stephen Hemsley, CEO of UnitedHealth Group, the nation's largest private insurer. He holds the No. 7 spot. UnitedHealth was the first insurer to announce it was pulling out of the Obamacare exchanges in most of its markets, citing deep and growing losses from the plans, which have drawn a larger proportion of older and sicker enrollees than expected. Aetna and Humana also have announced will be significantly downsizing their participation in the exchanges.
Marilyn Tavenner, as CEO of America's Health Insurance Plans, the primary lobbying group for the private insurance sector, is a leading voice in promoting the interests of the insurers—even though United and Aetna are no longer members of AHIP. Tavenner is No. 9 on this year's roster and it's her fifth time on the list, which includes her nearly two-year stint as CMS administrator.
She cites healthcare affordability as a key part of her mission as head of AHIP. “We still haven't solved that problem, as you well know. There's just a lot more that needs to be done to sustain it,” Tavenner said. “Some of that will involve pharma, some will involve hospitals, and some of it will involve us.”
Even as the nation's largest insurers face challenges in the courts and in making the exchanges a profitable enterprise, there's a prominent voice on this year's list who would like to put the private insurers out of business altogether.
Vermont Sen. Bernie Sanders, who led an insurgency against frontrunner Hillary Clinton in the battle for the Democratic nomination for the presidency, can be credited with single-handedly drawing the issue of single-payer universal healthcare back into the mainstream debate.