Humana to exit ACA exchanges for 2018

Louisville, Ky.-based Humana plans to no longer provide individual products through ACA exchanges effective Jan. 1, 2018. The insurer cited an unbalanced risk pool as the reason for its departure.

Here are six things to know about the withdrawal.

1. Humana said over the past several years it has shifted its networks and modified its individual products, including raising premiums, to address challenges faced on the ACA exchanges.

2. However, the insurer said Wednesday "these actions were taken with the expectation that the company's individual commercial business would stabilize to the point where the company could continue to participate in the program. However, based on its initial analysis of data associated with the company's healthcare exchange membership following the 2017 open enrollment period, Humana is seeing further signs of an unbalanced risk pool. Therefore, the company has decided that it cannot continue to offer this coverage for 2018."

3. Humana is the first major health insurer to announce plans to exit the 2018 ACA exchanges. The insurer covers about 150,000 individuals through plans sold through the exchanges, making it one of the smaller players in the business, according to a Forbes report.

4. The decision comes after Humana and Harford, Conn.-based Aetna called off their proposed $37 billion merger in light of a U.S. District Court ruling that blocked the transaction on the grounds that it would be anticompetitive.   

5. Humana said it will continue to serve policyholders across the 11 states where it offers individuals plans on the ACA exchanges this year. 

6. The withdrawal was announced as part of the payer's future expectations as an independent insurer. Humana projects full-year 2017 earnings per diluted common share guidance to be between $16.65 and $16.85, with an adjusted EPS guidance of between $10.80 and $11. 

More articles on payer issues:
Cigna ends merger agreement, sues Anthem for $14.85B: 3 things to know
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Colorado AG approves UnitedHealthcare's purchase of Rocky Mountain Health Plans

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