Obamacare continues to unravel as presidential election nears

SAN DIEGO (KUSI) — The signs are un-mistakable.

President Obama’s signature healthcare plan continues to unravel.

On Monday, Aetna decided to pull out of the Federal Exchanges next year, following the lead of United Healthcare.

While Aetna was never in the California Exchange, it’s exit will have an impact.

There was a time where people would have thought Aetna and United Healthcare might have gotten more active in California and bring more competition, but it never happened. And while neither are part of the Covered California Exchange, there is an impact.

Aetna and United Healthcare have collectively lost a billion and a half dollars in the last two years under Obamacare.

With two of the five biggest insurance companies withdrawing from the Federal Exchanges, there is a ripple affect, less competition and higher costs.

"California itself, regardless of Aetna’s decision, California has already asked for much greater premiums, double digit increases in premiums by several plans in those exchanges," said Dr. Ted Mazer of the County Medical Society.

The survival of these federal exchanges as a whole are in question.

"Either the rates go up, the benefits go down, or we need some very basic changes in what the exchanges are going to do and how the ACA, the Affordable Care Act, is going to work in the future," he said.

Dr. Mazer said the problem is that not enough young people who would pay into the system, but not need the healthcare are not buying health insurance.

"They decided that for them maybe taking the risk and paying the tax penalty was a better bet, and it is a bets it’s a gamble, but a better bet than buying into the exchange," Dr. Mazer said.

That leaves the older and sicker people to sign up and the vast majority of them are being subsidized by the taxpayers. Their premiums are as low as $15 a month.

This is what’s behind the premium spikes. We haven’t seen companies withdrawing in California, yet we continue to see increases, 13.2 percent for 2017, largely because the young and Hispanics are not enrolling.

"Without those people in large numbers in the exchange, the costs overall per beneficiary are greater and therefore the premiums have to escalate quickly," Dr. Mozer said.

Don’t be surprised to see other insurance companies pulling out of the exchanges.

"With these major plans pulling away, saying this is not a survivable business, something has to give, and the only things that can give are premium increases, benefit decreases or revamp the program," he added.

All of this is the result of predictions that were made that never panned out.

How Obamacare gets fixed depends on who the next president is. Hillary Clinton wants to tweak it and Donald Trump wants to replace it.  

Categories: Local San Diego News