Health insurers are grappling with how to craft their message to investors and the public about universal coverage as a growing field of Democratic presidential contenders backs moving the U.S. healthcare system toward expanded coverage.
Some of the nation's largest commercial payers weighed in on the proposals, many of which are branded as "Medicare for All" by proponents, during the first quarter earnings season. UnitedHealth Group CEO David Wichmann warned the proposals could lead to a "wholesale disruption" of the nation's health system, spooking investors and sending payer and hospital shares tumbling.
Wall Street's unfavorable reaction may have led other insurers to stay quiet on the coverage issue. UnitedHealth, the first payer to report first quarter earnings, reported its earnings more than two weeks ago. Most other payers reported financial results this week. Some, like Anthem and Cigna, sidestepped the universal coverage issue entirely.
The idea of Medicare for All is a policy most Democrats seemed wary of during the last presidential election cycle. Only Sen. Bernie Sanders, I-Vt., was outspoken in supporting a single-payer system.
As the 2020 election nears, the once-fringe idea is now far more mainstream among Democratic hopefuls. Some have even suggested eliminating private insurance altogether. This week, the Congressional Budget Office released a report giving a broad overview of the effects of a single-payer system. CBO did not score a particular bill and veered away from providing specifics.
"Establishing a single-payer system would be a major undertaking that would involve substantial changes in the sources and extent of coverage, provider payment rates, and financing methods of health care in the United States," the report said.
As CEOs addressed investors during quarterly conference calls, their tone and messaging varied, but one consistent theme emerged: The private sector has a role to play in any future healthcare reform.
"Regardless of what shape and form the next stage of health care takes, we remain confident that the private sector will play an essential role in both shaping and executing that next stage," CVS CEO Larry Merlo said on his call with investors, the first full quarter after acquiring payer giant Aetna.
"The path forward is to achieve universal coverage and it can be substantially reached through existing public and private platforms," UnitedHealth Group's CEO David Wichmann said.
And increased Medicare Advantage enrollment across the country over the past decade testifies to consumers' preference for private-sector solutions, Humana's CEO Bruce Broussard said. Insurers like Humana sell Medicare Advantage plans that seniors can opt to enroll in instead of traditional Medicare. MA plans bundle together different parts of Medicare benefits, making it a one-stop shop.
Centene's CEO also pointed out the prevalence of enrollment in managed care plans, touting 68% of Medicaid beneficiaries and 34% of Medicare recipients are enrolled in private managed care plans.
The insurance company executives' comments were carefully worded— exactly what might be expected for insurers' public statements on a hot button political issue. Humana and UnitedHealth CEOs were the only executives to use the Medicare for All label.
"We caution that such proposals do nothing to address our top challenge: a growing health care affordability crisis," America's Health Insurance Plans, the industry group representing insurers, said in a statement following a House hearing on Medicare for All. "While noting that the foundation for an effective health care system already exists, we urge Congress to build on the lessons learned in these markets to improve what’s working and fix what’s broken."