Dive Brief:
- Covered California Executive Director Peter Lee is taking UnitedHealth Group to task for "throwing the Affordable Care Act under the bus" in order to excuse its exchange losses and threatening to end its participation, Kaiser Health News reports.
- Lee suggests the insurer has caused "political frenzy that Obamacare doesn’t work" when it should look at its own role in losing $475 million in 2015 on individual policies, and a projected $500 million for 2016.
- Lee argues the insurer's losses are due to its own mistakes regarding its rates and networks.
Dive Insight:
Lee comes to the issue as an outspoken proponent of the ACA, though his view is echoed by a recent Urban Institute report that concluded UnitedHealth may have brought some of its losses on itself, KHN notes.
The institute found UnitedHealth had significantly higher premiums than other insurers in many major U.S. markets, as well as broader provider networks, which may have attracted higher cost healthcare utilizers.
Leerink Partners healthcare analyst Ana Gupte told KHN insurers' complaints about the exchange are valid, though at the same time, said UnitedHealth may have been hurt by its decision to enter the exchanges a year after its competitors.
As for whether UnitedHealth will participate in the market in 2017, Lee notes in California, that will be up to both the insurer and state exchange officials.