5 health insurance stories that defined 2015
The year 2015 was undoubtedly one of seismic change for the health insurance industry, with no shortage of game-changing headlines and issues.
The Affordable Care Act, once again, played a major role in shaping the direction of the industry, and the year saw everything from mega-mergers to controversy over wellness programs to the failure of a slew of consumer operated and oriented plans (CO-OPs).
Here's a look back at a few of the health insurance business news stories that resonated with our readers over the past year:
King v. Burwell ruling sets ACA on more solid ground
The Supreme Court released its long-awaited ruling on the King v. Burwell case in June, when the justices sided with the defendants and refused to eliminate federal subsidies for consumers in states that chose to not establish their own exchange. In its 6-3 ruling, the Court wrote that "Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter."
The decision not only prevented a health insurance "death spiral" but also allowed insurers and patients alike to focus on open enrollment for 2016. It also means that the ACA will maintain subsidized health insurance for an estimated 6.4 million Americans who would have otherwise lost their coverage.
The court's opinion had the immediate impact of sending hospital and health insurer stocks soaring. The ruling also made a splash in politics, as the 2016 presidential campaign aspirants either lauded the decision or promised to undo the ACA altogether if elected.
Mergers and acqusitions rock the industry
Aetna and Humana received approval from their shareholders to merge in October, and the companies say that Humana's strength in the Medicare Advantage sector and Aetna's experience in the commercial insurance market will make a strong and mutually beneficial partnership.
Anthem and Cigna's shareholders also approved their deal, though both mergers are facing a thorough review from federal and state regulators.
If the consolidation trend continues, some say it will create a single-payer system in the U.S. And many still have questions about what the large mergers mean, with the provider community issuing continued criticism of what they see as anticompetitive effects of the deals, joined recently by consumer advocates.
Experts and the CEOs and Aetna and Anthem also testified about the mergers in a series of congressional hearings this year.