Opponents Of The Aetna-Humana Merger Urge DOJ To Take Action
In other news, Politico Pro reports that enrollment in private exchanges is lagging behind consultants' expectations and in Georgia and California, an insurer faces lawsuits for sending ER reimbursements directly to patients. Meanwhile, The Associated Press details the high stakes and challenges involved in picking a health plan not associated with the workplace.
The CT Mirror:
Merger Opponents Ask DOJ To Block Aetna-Humana, Anthem-Cigna Deals
Opponents of the planned Aetna-Humana, Anthem-Cigna mergers have asked the U.S. Justice Department to block them in a letter that alludes to the controversy over Connecticut Insurance Commissioner Katharine Wade’s lead role in state regulatory approval of one of the deals. Many of the 43 signers of the letter to Renata B. Hesse, head of the DOJ’s Antitrust Division, were state medical societies, including the Connecticut State Medical Society. The Universal Health Care Foundation of Connecticut, the Connecticut Citizen Action Group, several other consumer groups and the United Methodist Church also signed the letter. (Radelat, 6/29)
Politico Pro:
Private Exchange Enrollment Lags Far Behind Expectations
Private exchanges were supposed to transform the way people got health insurance through work. As recently as three years ago, consulting firms were predicting that 40 million workers — about a quarter of the employer-based insurance market — would be enrolled in private exchange plans by 2018. ... But actual enrollment three years later has been nowhere near those rosy projections. Accenture estimates that just 8 million individuals, including retirees, are enrolled in private exchange plans this year. Just 2 percent of employers indicated they used a private exchange to provide coverage to employees last year, according to survey data from the Kaiser Family Foundation. (Demko, 6/29)
Kaiser Health News:
Ga., Calif. Hospitals Sue Blue Cross Plan For Sending ER Reimbursements To Patients
Blue Cross and Blue Shield of Georgia faces separate lawsuits accusing it of sending reimbursement money for emergency room care directly to patients — and not to the hospital because it isn’t part of the insurer’s network. That’s costing the hospitals money since patients don’t always turn over the funds, according to the lawsuits, filed by Polk Medical Center in northwest Georgia and Martin Luther King, Jr. Community Hospital in Los Angeles — 2,000 miles apart. Each suit also says some patients have sought to profit from receiving the direct payments for their ER care. (Miller, 6/30)
The Associated Press:
HMO, EPO, PPO, OMG! How To Navigate Insurance Plans
Hunting for the right health insurance plan outside the workplace used to involve a much lower risk of losing hair — from tearing it out in frustration. If a shopper could get coverage, the chain of events was often straightforward: Pick a plan, see a doctor and then wait for the insurer to eat most of the bill for that visit. But rising health care costs and the Affordable Care Act are changing the health insurance market. (6/29)
