One of the nation’s biggest health insurers is worried enough about a scenario in which it would have to pull out of Obamacare exchanges that its CEO is willing to talk about the possibility on national TV from Davos. It may be partly a signal to the administration to get this train moving, but it’s no doubt also a reckoning with reality. Obamacare is not attracting the uninsured, and if the administration would stop changing the rules long enough for insurers to get a handle on who is in the exchange population, they’d no doubt find that population is far more sick and expensive than it was supposed to be.
Aetna CEO Mark Bertolini told CNBC on Wednesday that Obamacare has failed to attract the uninsured, and he offered a scenario in which the insurance company could be forced to pull out of program.
The company will be submitting Obamacare rates for 2015 on May 15.
“Are they going to be double-digit [increases] or are we going to get beat up because they’re double-digit or are we just going to have to pull out of the program?” Bertolini asked in a “Squawk Box” interview from the World Economic Forum in Davos, Switzerland. “Those questions can’t be answered until we see the population we have today. And we really don’t have a good view on that.”
He said that so far, Obamacare has just shifted people who were insured in the individual market to the public exchanges where they could get a better deal on a subsidy for coverage. “We see only 11 percent of the population is actually people that were firmly uninsured that are now insured. So [it] didn’t really eat into the uninsured population.”
For Obamacare to work better, it needs more flexibility and choice of insurance programs, Bertolini said. “We need to make it a lot more simpler for people. There needs to be more choice. When you get more choice, you make it more of a market and you get more people in the program.”
Bertolini’s comments illustrate the bind the insurance industry is in—and, yes, they jumped in with Obama on this deal expecting a bunch of people to be forced to buy their product. Obamacare has failed in such a way as to force them to raise rates dramatically. If they raise rates dramatically, the very administration that needs them to stick with the program will be calling them bad apple patent medicine salesmen because vilifying them will be the only hope for politically extricating itself from its policy failure, at least temporarily. And, in the meantime, the industry can’t even get a handle on who is in the exchanges because the administration keeps changing the rules every five minutes. A couple of industry folks told me last week, even if the news about the make-up of the exchanges is bad, it’d be better to figure it out, get some experience with the population, and gauge what can be done for cost containment. Obama’s short-sighted game of switcheroo doesn’t allow much actuarial science to take place.