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Covered California exec blasts UnitedHealth for ACA criticism

Peter Lee says insurer isn't taking responsibility for its own shortcomings

The executive director of California's health insurance exchange is firing back at UnitedHealth after the nation's largest insurer threatened to stop selling Affordable Care Act policies in 2017, Kaiser Health News reports.

Peter Lee, executive director of Covered California, said UnitedHealth is responsible for its own failures due to a series of blunders on rates and networks that caused its considerable losses on individual plans in 2015. Lee says those losses are not the fault of the healthcare reform law.

"Instead of saying we screwed up, they said Obamacare is the problem and we may not play anymore," Lee said in an interview with California Healthline, which is affilated with KHN.

A recent analysis from the Urban Institute study found that UnitedHealth's premiums were higher than its competitors in many U.S. markets, and it also offered broader provider networks that tend to attract sicker customers who incur big medical bills, the KHN article notes. But the Obama administration is currently taking steps to prevent the misuse of special enrollment periods so people can't wait to sign up until they need care. 

On the other hand, Ana Gupte, a healthcare analyst at Leerink Partners, told California Healthline that while UnitedHealth has made some questionable business choices, it does have valid complaints about the exchange market. In addition to tightening the rules on special enrollment periods, federal officials need to revisit a risk adjustment program that compensates insurers for taking on costlier patients, she said.

This is not the first time the California exchange has butted heads with UnitedHealth. In January, Covered California rejected the insurance giant's bid to enter the California state exchange, with Lee saying that insurers are not free to enter the insurance exchange as they please and "undercut" rivals who have been involved since the beginning.

To learn more:
- read the KHN article

Related Articles:
UnitedHealth loses $720M on exchange plans in 2015
UnitedHealth's exchange exit threat: What it means
California exchange rejects UnitedHealth
CMS outlines changes to special enrollment period rules
CO-OP failures and United's threatened pullout won't doom the exchanges, report says