23-August-2016

The federal government recently blocked insurance giant, Aetna, from acquiring Humana which may have contributed to Aetna's decision to drop 70 percent of its health plans in the Affordable Care Act (ACA) markets. Amid continued losses, Aetna and other health insurers are hoping to change the ACA’s insurer vs. insurer risk adjustment program to align with the Medicare Advantage risk adjustment, where high risk is paid by the federal government rather than by insurers lower risk. As Mike Adelberg, Senior Director of FaegreBD Consulting, said in an article for Modern Healthcare, this “seems like a big lift in the present legislative climate.”

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