Dive Brief:
- Humana has released plans to pull several of its offerings from the ACA marketplaces, which will affect 100,000 customers currently enrolled in those plans.
- The company disclosed its plans last Friday in its third-quarter earnings report.
- Humana says the move is a result of higher-than-expected expenses from sick enrollees.
Dive Insight:
Humana's report points toward market conditions as its reasons for pulling the plans. However, the company recently experienced stock fluctuations following a statement by Democratic presidential candidate Hillary Clinton that criticized the pending mergers between Aetna and Humana, as well as Anthem and Cigna. Of all the insurers, Humana took the biggest hit, finding itself down 11.1% in two days.
“Operating results for the company’s individual commercial medical business continue to be challenged primarily due to the volatility related to the start of the healthcare exchange program created under the Affordable Care Act as well as the morbidity of membership served under this relatively new program,” Humana stated in its earnings report.
The company says the plans targeted for discontinuation had features that attracted a higher-utilizing member base than was projected when they were priced. “The transitory nature of the population served has also contributed to use of emergency room services and non-participating providers above priced-for levels,” it added.