Commonwealth Fund Report Shows That Medicaid, Medicare Accounted for 59% of Health Care Revenue for Largest Insurers

Thursday, December 7, 2017

Commonwealth Fund Report Shows That Medicaid, Medicare Accounted for 59% of Health Care Revenue for Largest Insurers

In 2016, Medicare and Medicaid accounted for nearly 60 percent of health care revenues reported by the five largest U.S. commercial health insurance companies (UnitedHealthCare, Anthem, Aetna, Cigna, Humana), according to a new Health Affairs study supported by the Commonwealth Fund. Revenue from public coverage has more than doubled since passage of the Affordable Care Act (ACA), growing from a combined total of $92.5 billion in 2010 to $213.1 billion in 2016.

While the top five insurers have remained profitable by increasing their Medicaid and Medicare enrollments, some have recently made decisions to leave the ACA marketplaces in several states, even as they continue to enroll people in non-ACA government-sponsored coverage.

The authors suggest that to improve the stability of the marketplaces, policymakers consider requiring that insurers offer coverage in the marketplaces if they participate in Medicaid and Medicare in the same geographic area. Nevada and New York have such requirements for Medicaid plans.

"Many states' ACA marketplaces are facing uncertainty about insurer participation and have fewer choices for consumers, as some insurers have left the markets," said Cathy Schoen, lead author of the study and a senior scholar at the New York Academy of Medicine...

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