UnitedHealth Group may exit Obamacare market in 2017

Paula Burkes by Paula Burkes Published: November 19, 2015 /Updated: Nov 19, 2015/

UnitedHealth Group, one of two insurers in Oklahoma's healthcare.gov marketplace for 2016, on Thursday slashed its earnings outlook, citing Obamacare problems, and said it may exit the program's exchanges in 2017.

The announcement drew concern and clarification from local health insurance agents and Blue Cross Blue Shield of Oklahoma, which dominates the state market.

"If United exits, there will only be one option," said Matt Hensley, president of Cover Oklahoma. "However, there may be many in the Moore-Norman area who will be moving to United in 2016, due to network gaps with Blue Cross."

Some Moore and Norman hospitals are no longer in the Blue Cross Blue Shield network on individual policies bought on healthcare.gov, he said.

Blue Cross Blue Shield of Oklahoma spokeswoman Ashley Hudgeons said, "To continue to offer sustainable healthcare options, we had to make the difficult decision to no longer offer the Blue Choice PPO network to consumers in the individual market, beginning Jan. 1."

"Eighty percent of our members enrolled in individual plans will not be impacted by this change," Hudgeons said. And to ensure there's no gap in coverage, Blue Cross Blue Shield Oklahoma automatically will transition impacted members to a comparable plan, she said. Members will have the option of choosing a different plan, or choosing another carrier, during the open enrollment period, she said.

Meanwhile, United CEO Stephen J. Hemsley said in a news release Thursday, "Growth expectations for individual exchange participation have tempered industrywide, cooperatives have failed, and market data has signaled higher risks and more difficulties while our own claims experience has deteriorated."

When asked about enrollment in United plans thus far on the Oklahoma exchange, spokesman Tyler Mason said, "It's early days and historically we do not break out our state enrollment data for exchange offerings."

United currently has some 550,000 members in 23 states, Mason said. By 2016, the insurer will be in 34 states, he said.

Insurers have had trouble signing up young and healthy individuals on the Obamacare exchanges, which is necessary to offset the costs of covering older and sicker enrollees. This has forced premium hikes, deductible increases, and fewer doctors and hospitals on its plans.

Paula Burkes

A 1981 journalism graduate of Oklahoma State University, Paula Burkes has more than 30 years experience writing and editing award-winning...