A Different Way to Look at The Reasons for the Government Shutdown

FLORIDA
Opinion by:  E. Eugene Webb PhD

The Democrats continue to say the reason why they will not meet on the budget with the Republican House or Senate is their desire to continue the Affordable Care Act health care premium subsidies.

For a look at the providers of those health care insurance policies and their revenues for 2024, here are five of the top health insurance providers participating in the Affordable Care Act (ACA) marketplace, commonly called “Obamacare” plans (in states with marketplace exchanges and subsidized coverage). These companies are significant players based on enrollment, state-exchange presence, and market data.

Rank	Provider	Notes on ACA Marketplace / Subsidized Plans
1	Centene Corporation	Identified by the American Medical Association (AMA) as the largest insurer in the ACA individual-market/state-exchange space nationally (~14–17 % of exchange market) in recent years. American Medical Association+2American Medical Association+2
2	Blue Cross Blue Shield of Florida (BCBS Florida)	While state-specific, the AMA identifies this Blue Cross / Blue Shield affiliate as among the largest nationally in exchange market share (~9 %) in recent data. American Medical Association+1
3	Kaiser Permanente	A significant integrated health insurer participating in multiple state marketplaces; listed among the top exchange insurers (~7 %) in some data. American Medical Association+1
4	Bright Health	Identified in exchange-market rankings among the top insurers (~7 %) by market share for the individual-market (ACA) context. American Medical Association
5	Oscar Health	Although smaller in total share, Oscar appears in the top 10 ACA-exchange insurers (~5 %) in national data. American Medical Association

Source: Chat: Notes / Caveats:

• These rankings reflect national aggregate data for enrollment or market share in ACA exchange/subsidized plans, not necessarily state-by-state dominance.
• Exact rankings can vary significantly by state and year, because insurer participation, subsidies, and state-exchange rules differ.
• Some large insurers overall (e.g., UnitedHealth Group) have limited or minimal ACA-exchange participation in certain states despite being large health-insurer players overall.
• “Subsidized” refers to health plans purchased through the ACA marketplace where income-based premium tax credits or cost-sharing reductions apply.

Here are the 2024 annual revenue figures for the companies

Provider	2024 Revenue
Kaiser Permanente	≈ US$ 115.8 billion Kaiser Permanente+2Fierce Healthcare+2
Blue Shield of California	≈ US$ 27.44 billion Blue Shield of California | News Center+1
Molina Healthcare	≈ US$ 40.65 billion Macrotrends+1
CVS Health Corporation (Parent of Aetna)	≈ US$ 372.8 billion Q4 Market Intelligence
Health Net (subsidiary of Centene)	Revenue not clearly published for 2024 in publicly accessible sources

From Chat: I wasn’t able to locate reliable, detailed data that specify exactly what portion of each company’s revenue comes directly from federal subsidies

It's a known fact that organizations like healthcare institutions and insurance companies tend to use up all the money that's available from the government in one form or another.

Maybe it's time for the Democrats and the Republicans to get back to work and put together some enforceable legislation that limits the number and amount of subsidy reimbursements to healthcare providers and reduces the subsidies to insurance companies but does not allow them to reduce services. Above is a quick glance provided by Chat GPT on the revenues of the providers of these insurance premium subsidies.

Medical providers and the big healthcare companies will continue to charge exorbitant prices to accomplish the greatest reimbursements from the insurance health care companies. The affordable health Care Act insurance providers will adjust premiums to soak up all the money the federal government will allow them to charge.

It's time for the federal government to step in and manage the amount of revenue spent on medical services through Medicare and premium reimbursements. The government isn't getting its money's worth, and neither are you.

Artificial intelligence disclaimer

The data for this post was developed using Chat GBT.  It may contain errors, estimates, and other assumptions.

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