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Insurers are under fire for making large profits

The Energy and Commerce Committee calls for a reporting as AHIP says the next half-year could bring higher costs as the amount of care increases.

Susan Morse, Managing Editor

As insurers report large second-quarter profits due to the delay of elective surgeries during the pandemic, the Energy and Commerce Committee has called upon the companies to do more to provide immediate relief and has said it would launch an investigation into their business practices.

America's Health Insurance Plans has defended insurers, saying they pay for testing and treatment even as Energy and Commerce Committee Chairman Frank Pallone, D-N.J., said he is concerned by reports that insurers are denying coverage for testing.

"Large-scale testing is the only way we can get beyond this crisis, and insurers who are imposing restrictions on coverage of COVID-19 testing are making this task harder," Pallone said. "I want to know if they're in compliance with [the] existing statute requiring COVID-19 testing be free of consumer cost-sharing for all patients and how they intend to use their profits to help the American people during this time of crisis."

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Pallone has called upon insurers to reduce premiums and extend policies to eliminate cost-sharing for COVID-19 treatment through the end of the public health emergency. Insurers should also extend low- or zero-interest loans to community providers, he said. 

AHIP indicated that, while insurers are saving money now, costs will only rise as patients return to their physicians for regular care and delayed procedures and also for COVID-19 care.

"The number of COVID-19 cases is unfortunately continuing to grow day by day," AHIP said. "Those affected patients must have the same level of access to care and treatment. Hopefully one day soon, health insurance providers will cover an approved, CDC-recommended vaccine once one is available."

There is growing evidence that some COVID-19 survivors face months, or possibly years, of debilitating complications, AHIP said. Initial numbers for long-term costs "are staggering as the estimated treatment costs for COVID-19 range from $30 to $547 billion over a two-year time period." 

WHY THIS MATTERS

Pallone said Thursday the committee will launch an investigation into health and dental insurance companies' business practices following reports that many of the companies are recording record profit margins during the COVID-19 pandemic.  

Anthem and UnitedHealth nearly doubled their profits during the second quarter. 

UnitedHealth Group, the parent company for insurer UnitedHealthcare, reported profit of $6.6 billion in the second quarter, which is about double the net income from the same time last year.

CVS Health reported an adjusted operating income increase of 140.9% in its healthcare benefits segment during the three months ending June 30, compared to the prior year. CVS owns Aetna.

"The increase was primarily driven by reduced benefit costs due to the deferral of elective procedures and other discretionary utilization in response to the COVID-19 pandemic, growth in the segment's government products and the impact of cost-reduction efforts, including integration synergies," CVS said.

Profits for Cigna and Humana were also higher.

AHIP said insurers have been taking action during the pandemic by offering grace periods and premium discounts. They've also taken steps to support workers and hospitals through financial and other assistance with relief funds, direct donations and advancing billions of dollars in assistance. 

"Since COVID-19 began impacting the patients and communities our member companies serve, health insurance providers eliminated patient cost-sharing for COVID-19 testing and treatment – prior to any government requirements.  We've expanded access to care by enhancing telehealth services and waiving cost sharing.  And with the uncertainty and anxiety created by the virus across people of all ages and all walks of life, health insurance providers have launched new mental health services and supports for millions of Americans." 

THE LARGER TREND

Insurers are required by the Affordable Care Act to refund excess profits.

But with more than 4.8 million confirmed cases of COVID-19 in the U.S., it's hard to project the future cost of care.

"The second half of the year could see a lot more care, and higher costs, than the first half of 2020," AHIP said. "However, if these costs never materialize and remain below certain levels, American consumers, businesses and taxpayers are protected by provisions in federal and state laws that require health insurance providers to deliver premium rebates and put money back into their pockets."

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com