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Large Insurer Exiting Workplace Health Insurance Market

February 25, 2023

Summary: Humana announced a pivotal business strategy change that suggests the looming culmination of a massive shift in US health insurance. Job-based insurance started in WWII, and dominated the health insurance business … until insurers convinced government to let them manage large parts of Medicare & Medicaid, while also buying up prescription benefit managers and providers. The privatization train must be stopped, with single payer.

Humana lays out exit from employer-sponsored coverage
ABC News
February 23, 2023
By Tom Murphy

The health insurer Humana will stop providing employer-sponsored coverage as it focuses on bigger parts of its business, like Medicare Advantage.

The insurer said Thursday it will leave the employer-sponsored business over the next 18 to 24 months. That includes coverage provided through private companies and for federal government employees.

Employer-sponsored health insurance is one of the most common ways for Americans to get coverage, but it amounts to a small part of Humana’s enrollment. That is centered largely on Medicare Advantage, the privately run version of the federal government’s Medicare program for people age 65 and older.

Humana also will continue to provide coverage to nearly 6 million military service members and their families.

Humana also runs Medicaid coverage for states and provides stand-alone Medicare prescription drug coverage. The insurer covered about 13.5 million people last year, not counting the stand-alone prescription drug plans.

Employer-sponsored coverage made up around 7% of that total.

Humana CEO Bruce Broussard said in a prepared statement that the exit from employer-sponsored coverage lets Humana focus its “greatest opportunities for growth.”

The company also said its employer-sponsored business “was no longer positioned to sustainably meet the needs of commercial members over the long term or support the company’s long-term strategic plans.”

Enrollment growth in employer-sponsored insurance has stagnated for many years for insurers, including market leaders like UnitedHealthcare. Insurers have turned more to government-backed coverage like Medicare Advantage or managing state Medicaid coverage for enrollment growth.

They also have pushed deeper into managing prescription drug plans and buying care providers in order [they say] to control health care costs.

Shares of Humana Inc., based in Louisville, Kentucky, climbed about $1 to $504.60 Thursday.

Comment by: Don McCanne & Jim Kahn

The key paragraph is: “Enrollment growth in employer-sponsored insurance has stagnated for many years for insurers, including market leaders like UnitedHealthcare. Insurers have turned more to government-backed coverage like Medicare Advantage or managing state Medicaid coverage for enrollment growth.” And they’re expanding their role and power: ”They have pushed deeper into managing prescription drug plans and buying care providers …”

Private insurers are taking over public health insurance programs, reaping profits from each step in medical care funding and delivery. They recognize government largesse when they see it, and reel it in. They exercise massive market and lobbying power to create rules that help them gobble up our public health insurance resources, fueling record profits.

What intentions do they have for Medicare For All? Doesn’t this look like a setup for Medicare Advantage for All? A public insurance program under control of the private insurers? With their additional use of private equity to gain ownership of the delivery system?

We know this would waste massive resources while denying needed care. Private insurance-mediated Medicare and Medicaid are more expensive and deny or delay care through prior authorization, narrow networks, and patient cost-sharing obligations.

The battle lines are set! The wealth of the billionaires versus the health of the people. Further inertia on the part of us, the people, will result in their inevitable control.

We have the ultimate move that can tip the balance toward health, if we act soon. That, of course, is to implement an improved, publicly-administered Medicare that covers everyone. What do we want to use the people’s money for? More wealth for the wealthy, or more health for the people?

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