Home > Health Care Policy > States dropping For-Profit Health Insurance Companies from Medicaid Programs

States dropping For-Profit Health Insurance Companies from Medicaid Programs

As of today, The great state of Ohio has taken the right step and has kicked out private for -profit health insurance company Aetna from insuring people in Ohio’s Medicaid program. This comes only 2 months after Aetna received the green light to manage 1.7 million recipients. The contracts were supposed to go into effect January 1 of next year. It is unknown as to why Aetna was dropped (source 1).

Ohio is not the only state to have recently stopped awarding state Medicaid contracts to Aetna and other large 4-profit companies. In December 0f 2011, the great state of Connecticut made a great decision and kicked out UnitedHealthcare and Aetna from managing its Medicaid recipients as well. State officials are reported as saying to USA Today that the companies were dropped for “not fulfilling their promise to lower costs and provide better care.” (source 2). This whole thing of “not fulfilling their promise to lower costs and provide better care” is unfortunately becoming an epidemic in this country to when it comes to insurers. This goes ditto for the 4-profit ones. These especially are getting caught more and more by the federal government for defrauding Medicare and Medicaid on purpose in order to get profits for their shareholders. Sadly, this situation is turning into the “plague”.

According to research that I have done, I have found out that Aetna and UnitedHealthcare collectively have paid out over $596 million in settlements over the past 5 years for having been caught defrauding Medicare and Medicaid (actual amount defrauded before settlement to be posted on blog soon). Total amount by insurers over same time period is nearly $3,000,000,000 (source 3). This situation is clearly getting worse. State governments have finally “smelled the Starbucks” and have realized that the best prescription for curing this problem is to simply kick out the 4-profit companies from state Medicaid programs. Hopefully more states will follow suit and drop for-profit health insurance companies from their Medicaid programs.

Sources:

1. http://online.wsj.com/article/SB10001424052702303753904577452362620192458.html

2. ttp://www.kaiserhealthnews.org/Stories/2011/December/29/Connecticut-Drops-Insurers-From-Medicaid.aspx

3. https://medaccessforamerica.wordpress.com/2012/05/14/health-insurers-fined-4-3-billion-for-medicare-fraud-and-other-fraud-violations/

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  1. August 23, 2012 at 5:20 am

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