Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

This is precisely why single payer is desperately needed. And proof that Obamacare is a Rube Goldberg machine. I remember listening to a Kentucky senator who said they were gobsmacked that no insurance company signed up in his state. The program is based on wishes, not good practices. Having Justice tinker with antitrust to keep it alive will never work. Insurance companies could give a F about their policy holders, their shareholders and profits are the only ones who count.

This is not proof at all that "Obamacare is a Rube Goldberg machine." This is a major insurer pulling out the markets, but over trivial amounts of losses.

I don't know what you mean about Kentucky. There are plenty of health insurance companies with offering on the Kentucky exchanges (Anthem BCBS, CareSource Kentucky, Humana, Aetna, and Bluegrass Family Health). And in any event, even if there truly were no insurance companies with offerings on the Kentucky exchanges, I find it very implausible that either Mitch McConnell, or Rand Paul would have claimed to be "gobsmacked." They were leaders in the fight against ACA, and they certainly claimed before passage that the law would destroy the health care industry.

I don't think it's fair to categorize Aetna's annual loss of ~300M as trivial. That represents about 12.5% of their profits. If someone cut your salary by 12.5% I don't think you would think that was trivial.

Salary is analogous to revenue not profits.

Salary is the money I get from my employer to buy stuff with.

If I'm a shareholder of a company, then my cut of their profits (not revenue) is money I get to buy stuff with.

Profits is the money left over after expenses. This is not what salary represents to the average worker.

Edit: not a 3 year number

I should clarify, I didn't mean it was trivial to Aetna. I meant it was trivial compared to the cost of the existing subsidies and risk corridors in the ACA, and that this is not an existential problem for ACA.

Over the past few months, several major insurers have either reduced or ended their participation in the ACA exchanges. That is troubling news. However, setting aside the political feasibility, it's hardly an unsolvable problem. If the risk pool does not improve, and insurers keep losing money, then we can raise funding for the risk corridors.

To put this in perspective, Aetna, one of the largest insurers in the marketplace, is losing about $300 million. We're spending about $200 billion/year on ACA currently.

OK that's fair. I pretty much agree with everything you say here.

I think I am more concerned than you are that the structure of the exchanges will make them untenable in the long term but that's certainly a judgement call and we won't know the real answer for several years at least.

I'd say a public option would be the way to "soft introduce" single payer. Just expand Medicare to anyone who wants it on the exchanges. Once the premiums shake out, "big bloated government" likely will be pretty competitive.

Of course that would require a major shift in the House of Representatives, which probably won't happen until the 2022 election, after electoral maps are redistricted in 2020 post-census, and the rampant gerrymandering might be fixed. And some kind of political cover from the caterwauls sure to emanate from the health insurance industry.