This is Jacob Emerson with the Becker's peer issues podcast. Here's your biweekly industry news briefing for September 11th. Well, immigration and the economy emerged as major topics during the 90 minutes presidential debate on September 10th between former president Donald Trump and vice president Kamala Harris. But the 2 candidates did spend some of their time on 2 health care topics, abortion and the Affordable Care Act. The a ACA surface surface as a topic
near the end of the debate. 1 of the moderators asked mister Trump if he still intended to replace the health care law, and if so, what his plan would be. When pressed by the moderator, mister Trump said he has concepts of a plan and that he, quote, would change it if we come up with something better and less expensive. And there are concepts and options we have to do that, and you'll be hearing about it in the not too distant future, end
quote. The Republican Party has shifted away from its longstanding campaign to repeal the ACA passed under president Barack Obama in 2010. The health care law reemerged in this election cycle when mister Trump in November used Truth Social to identify health care as a key issue in his 2024 campaign, promising to replace the ACA if reelected. According to a tracking poll conducted by KFF, 43% of adults supported the health care law in November of 2016.
The latest survey conducted in this April showed 62% of Americans hold a favorable opinion of the ACA, while 37% view it unfavorably. In 2021, the Biden administration enacted the American Rescue Plan Act, which temporarily enhanced subsidies for individuals purchasing health coverage through ACA marketplaces, was set to expire at the end of 2025 without congressional action.
The Biden administration has also released new data on September 10th showing that 1 in 7 US residents have been covered through marketplace coverage since January of 2014. During the debate, miss Harris emphasized her commitment to maintaining and growing the ACA, highlighting that the law prevents insurance companies from denying coverage to those with preexisting conditions.
Well, coming mid October, the Medicare Advantage Program will enter its annual enrollment period marked by significant changes for older adults. Among these changes are increased government scrutiny, tighter CMS regulations, reduced base payments, and rising health care costs.
The CEO of 1 Insurance Marketplace also wrote online that in addition, the presidential election will distract beneficiaries during the early weeks of the enrollment period, and the late Thanksgiving holiday will cause many beneficiaries to delay their decision making until the final week, adding more stress to an already difficult situation.
We also know that the health insurance industry is launching a 7 figure lobbying blitz in Washington, which includes a national digital and social media campaign to reach seniors and counter mounting challenges and highlight the benefits that Medicare Advantage Plans can offer to that population. In response to these market shifts, MA carriers are prioritizing their margins over membership by reducing certain benefits and exiting unprofitable
markets. As margins tighten and negotiations with providers become more strained, some, usually smaller health systems, are choosing to no longer accept some or all MA plans usually from larger carriers.
Sachin Jain, the CEO of Scan Group, a nonprofit Medicare managed carrier with more than 285,000 members, he wrote on LinkedIn earlier in September calling all of this, quote, the great disruption, and he outlined 5 key observations about the evolving landscape, saying that benefit stability will win out among beneficiaries over innovation, that MA organizations will need to improve care management abilities, that competition in the industry will increasingly
focus on plan effectiveness and the quality of service. The brokers are becoming more important than ever, and the stronger relationships will prevail will prevail over partnering with everyone. Well, Aetna and HCA hospitals in Florida will go out of network if the two sides do not reach a new contract agreement before September 15th. HCA and 48 of its hospitals in Florida will be out of network if a new contract agreement
is not reached. HCA's contract with Aetna's commercial and individual plans expires September 15th. HCA's Florida hospitals will remain in network with Aetna Medicare Advantage through October 2025. The contract negotiations do not affect ASC's urgent care facilities or other facilities according to HCA, and both sides are working to avoid a split.
Well, speaking of contract negotiations, Mercy Health in St. Louis has notified Anthem Blue Cross Blue Shield that it will go out of network with the insurer in Missouri if a new agreement is not reached by January 1st. That contract includes all commercial, Medicare Advantage, ACA, Managed Medicaid, and Health Link. Mercy's retail pharmacy services would not be affected
by any potential split. The health system said it wants to remove the, quote, red tape that makes it difficult for patients to navigate Anthem's system and acts as a, quote, barrier for patients to receive medically necessary care. Both of those organizations are continuing to negotiate. And finally, Centene expects rising Medicaid pressures to hurt its 3rd quarter earnings. In documents filed with the SEC on September 10th, Centene said it expects Q3 earnings per
share to decline by 20 to 30¢. Those earnings will shift to the Q4. The company is maintaining its full year earnings guidance of at least $6.80 cents per share. Its CFO, sir Drew Asher, on September 4th, said the company expected medical expenses in Medicaid to be higher in the Q3 than in the Q2. The company's medical loss ratio in the Q2 was 87.6%. They said that Medicaid redeterminations have been the main driver of increasing costs.
Centene lowered its Medicaid membership guidance for 2024 from 13,600,000 to 13,000,000. If you like the latest health insurance industry news delivered straight to your inbox, subscribe to the Becker's payer issues e newsletter on our website at beckerspayer.com.