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December 16, 2016 11:00 PM

The 2016 Year in Review: Insurance

Bob Herman
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    Growing instability in the Affordable Care Act's insurance exchanges was the biggest storyline in health insurance for 2016.

    It started in April when UnitedHealth Group CEO Stephen Hemsley said his company would only sell individual-market exchange plans in a handful of states in 2017 due to more than $1 billion in losses in 2015 and 2016. Aetna and Humana soon followed with similar retreats.

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    There was a subplot that got less attention. Not-for-profits like Kaiser Permanente and some Blue Cross and Blue Shield plans, such as Florida Blue, reported making money or breaking even on exchange products.

    Still, most insurers said they weren't getting enough younger, healthier people to balance out the costs of older, sicker members. They also complained that some consumers gamed the system by signing up to get care and then dropping coverage. In addition, people with incomes too high to qualify for ACA subsidies struggled to afford rising premiums and out-of-pocket costs.

    More on a year in review

    It all looks so different now...

    Politics and policy

    Public health

    Medicaid

    Drugs and devices

    Winners and losers

    Payment reform

    Provider M&A

    Technology

    The Obama administration's announcement in October that individual-market premiums would rise by an average of 22% across the country created political turbulence for Democrats heading into the November elections.

    Rising out-of-pocket costs were an issue in employer-based plans as well. Kaiser Family Foundation data showed that premium growth slowed somewhat in 2016 because more employers shifted workers into high-deductible plans. Drew Altman, the foundation's CEO, called the cost shift to consumers “the biggest change in healthcare in America that we are not really debating.”

    The entire industry, meanwhile, watched closely as the Anthem/Cigna Corp. and Aetna/Humana merger plans proceeded. The U.S. Justice Department sued to block both deals, and the trials got underway in the final weeks of the year.

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    • Blogs
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      • From the Editor
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        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - AI and Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
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