by Andrew Walden

Just as in Hawaii, the Obamacare Exchanges in other states are not attracting insurance competitors.  Meanwhile--just as in Hawaii--Sen. Majority Leader Harry Reid (D-NV) is predicting that single-payer will be the result of Obamacare. 

Here are links to the national stories and their corollaries in Hawaii.... 

Las Vegas Sun: Reid says Obamacare just a step toward eventual single-payer system

In just about seven weeks, people will be able to start buying Obamacare-approved insurance plans through the new health care exchanges.

But already, Senate Majority Leader Harry Reid is predicting those plans, and the whole system of distributing them, will eventually be moot.

Reid said he thinks the country has to “work our way past” insurance-based health care during a Friday night appearance on Vegas PBS’ program “Nevada Week in Review.”

“What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever,” Reid said.

When then asked by panelist Steve Sebelius whether he meant ultimately the country would have to have a health care system that abandoned insurance as the means of accessing it, Reid said: “Yes, yes. Absolutely, yes.”

The idea of introducing a single-payer national health care system to the United States, or even just a public option, sent lawmakers into a tizzy back in 2009, when Reid was negotiating the health care bill.

“We had a real good run at the public option … don’t think we didn’t have a tremendous number of people who wanted a single-payer system,” Reid said on the PBS program, recalling how then-Sen. Joe Lieberman’s opposition to the idea of a public option made them abandon the notion and start from scratch.

Eventually, Reid decided the public option was unworkable.

“We had to get a majority of votes,” Reid said. “In fact, we had to get a little extra in the Senate, we have to get 60.”

Pushing for Single-Payer in Hawaii: Open Letter: Hawaii MDs Challenge “Severely Dysfunctional” Medicaid Program

Hawaii Obamacare Leaders Warn: “We’re not Going to Have Any Health Care”

Email Chain Reveals Hawaii Obamacare Leaders Debating “Inevitable Failure”

  *   *   *   *   *

CNS: Blue Cross, Aetna, United, Humana Flee Obamacare Exchanges 

Aetna, a fortune 100 company with $34.2 billion in revenue, has pulled out of the government-run exchanges in three states, including the state of Connecticut, where it is based.

Founded in Hartford, Conn., in 1850, Aetna withdrew its application to participate in that state on Monday, the Hartford Courant reported. The company said it was withdrawing from there and in Georgia and Maryland because limitations the state governments would impose on their rates would not allow them to make money.

“We have spent considerable time identifying those states in which we can be competitive and add the most value to the market,” Aetna said in a statement.  “As a result of our analysis, we have reluctantly concluded that we will withdraw certain Individual Exchange filings for 2014, including filings in Connecticut, Georgia and Maryland.”

“This is not a step taken lightly, and was made as part of a national review of our Exchange strategy,” the company said.  “Unfortunately, we believe the modifications to the rates filed by Aetna will not allow us to collect enough premiums to cover the cost of the plans and meet the service expectations of our customers.”

Aetna will also not participate in California’s exchange, and a spokesperson told CNSNews.com that the company never intended to do so.(

“We did not withdraw exchange plans in California, as we never planned participation nor filed [Qualified Health Plans] QHPs to participate in the California exchange,” a spokesperson said.

Anthem Blue Cross has withdrawn its bid to participate in the California's government-run Obamacare exchange marketing insurance to small businesses.

United Health Group, the largest health insurer in the United States, has taken a pass on California's individual health insurance exchange.

Aetna will stop selling health insurance policies to individuals in California all together, leaving nearly 50,000 existing individual policyholders to find new coverage by January. The company will continue to directly sell health insurance to employers in California--outside of the government exchange system

  *   *   *   *   *

Star-Advertiser: HMSA, Kaiser Will Monopolize State Health Exchange, 'Rate Shock' Predicted

The federal health reform law known as Obamacare aims to boost competition in the medical insurance market and drive down costs by making it easier for consumers to compare policies offered by different companies.

In most states consumers will be comparing policies from five or more carriers when their versions of a health connector, an online marketplace for medical insurance, goes live on Jan. 1, the Obama administration said Wednesday.

But not so in Hawaii.

The Hawaii Health Connector will have only two medical insurers, Hawaii Medical Service Association and Kaiser Permanente Hawaii.

"There's a lack of competition in the state of Hawaii, period," said Rick Budar, the Connector's chief marketing officer. "At this point, there are no other medical carriers that have submitted plans to the state. We are definitely trying to get more competition in the state. There are a number of carriers that have expressed interest. That's one of the missions: to create more competition and a level playing field. Through the ACA (Affordable Care Act) and the efforts of the Hawaii Health Connector, it may spur more competition moving forward. That is the hope."

Other insurers — including University Health Alliance and Hawaii Medical Assurance Association — have decided not to participate on the exchange, some citing the difficulty in competing with the largest health plans in the state and uncertainty as to the size of the potential market.

Hawaii has relatively few health insurance companies in part because for-profit insurers are subject to a state premium tax, an issue that in 2010 drove Summerlin Life & Health Insurance Co. out of business here.

Without more competition, Hawaii consumers may find rates going up once the law takes effect.

HMSA executives have warned consumers of "rate shock" as the law rolls out next year because there will be a pent-up demand for medical services among people who haven't had health insurance, as well as fees for operating on the exchange — costs that will be passed on in consumers' health plan rates.

2012--How we got here: "Sen. Roz Baker Blasted Over Hearing Conduct"

PEW: Lack of Competition Might Hamper Hawaii Health Exchange

PEW: New Health Exchange Unlikely to End Insurance Monopoly in Hawaii

How HMSA Used Health Care Advisory Council to Establish Medical Monopoly

Kaiser Health News: New Health Exchanges Unlikely to End Insurance Monopolies in Some States

If Obamacare Collapses: How States Can Protect Their Citizens