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Big Insurers decide not to play

How will massive health care reform pan out for Americans in 2014? The answer is no one knows for sure. What are the largest health care insurers doing to get ready for the implementation of Obamacare? According to a new CNN report, many of the largest insurers such as Aetna, UnitedHealthcare and Cigna have taken a wait and see approach.


What are insurers waiting for?


According to Christine Monahan, a former senior health policy analyst with Georgetown's Center on Health Insurance Reforms, there are simply a lot of “unknowns,” like how many unhealthy American, who have not previously had insurance coverage, will come flooding  into the market with expensive medical needs.

One of the biggest insurers, Aetna, has actually withdrawn their insurance proposals from five exchanges. Aetna has stated, “they need to reevaluate whether their plans are “competitive and financially viable, in order to meet the long-term needs of the exchanges in which we choose to participate.” Currently they will not have policies in Maryland, New York, Georgia, Ohio or their home state of Connecticut.

What are they planning to do instead? Aetna has decided to offer their own individual plans outside of Obamacare in New York, at least for now. Other state plans will also be reviewed to determine the best course of action for Aetna.

UnitedHealthcare’s plans are very similar to Aetnas. UnitedHealthcare will have very limited participation in state exchanges this year but has stated they will take 2014 to evaluate their options and determine if state exchanges are a potential “growth market” for them. Cigna also has a similar strategy. Right now the company has decided to join the exchanges in five states.

Other companies such as WellPoint, however, have taken a different approach than other large insurers. WellPoint is a Blue Cross Blue Shield licensee and they plan to offer insurance options in 14 states.

What will this mean for consumers?


Some experts claim the absence of many larger insurers on the exchange is not necessarily such a bad thing, although there are some concerns that smaller regional companies who offer plans will not have as extensive a list of doctors and hospitals in their networks. One expert noted that this is “one of the trade-offs for affordability.”

What do the doctors say?


But do the doctors agree? According to a recent WND article, “Many doctors are concerned that the practice of medicine is in jeopardy as medical experts lose control of their clinics and compensation with the implementation of the Affordable Health Care for America Act, or Obamacare.”

Others claim that many doctors are already leaving their profession or seeking alternatives to what they see as a the “federal government’s takeover of health care.” Others note that doctors are already limiting the number of patients they will see who are covered by Medicaid and Medicare because of low reimbursement rates.

What happens when thousands of new patients flood the market on Obamacare? No one knows for sure, but it should be clear to everyone that having insurance is not the same as finding a doctor to provide you with great service.
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