Humana Says It’s Out of Individual Markets, Regardless of Any New Legislation

The Affordable Care Act—also known as the ACA, or “Obamacare”—famously drove many insurers out of state exchanges due to the difficulty they had in turning a profit through their participation. President Trump says the plan he’d like to see in place would be both superior and less expensive than his predecessor’s. Humana isn’t planning on sticking around to find out, however, and has announced it will not be participating in any individual insurance market after it exits ACA plans later this year. The company says the essence of participating in such plans simply does not jibe with the way they do business. What they’re “good at,” they say, is managing care for members of public plans like Medicare, Medicaid, and Tricare—plans in which there is little or no risk, basically—leaving industry experts to wonder whether they’re going to really be an insurance company at all, or merely a claims-processing company that makes money off premium “float.” The concern in the urgent care marketplace is that focus on population health management leaves independent/independent/one-off urgent cares out of the equation.