The hottest Insurance Substack posts right now

And their main takeaways
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Thanks to reporters at ProPublica and Scripps News, we are learning more about how health insurers cheat patients out of life-saving care

HEALTH CARE un-covered • 339 implied HN points • 30 Nov 23
🏥 Health Politics Insurance
  1. Health insurers often ignore laws meant to help patients get crucial medical care. This can result in patients not receiving life-saving treatments they need.
  2. Many patients don’t complain about insurance denials because they are overwhelmed during difficult times. This makes it hard for regulators to catch insurers doing wrong.
  3. State insurance departments are usually underfunded and struggle to enforce laws, which allows insurers to keep profiting while patients suffer.

On Insurance

Something to Consider • 59 implied HN points • 03 Jun 24
💰 Finance Insurance
  1. Moral hazard happens when people take more risks because they have insurance, like thinking they can be careless if they have fire insurance. This means insurance can't cover every behavior to keep premiums fair.
  2. A better way to provide insurance is to focus on events that you can't control, like natural disasters, rather than paying out for specific losses. This keeps people motivated to protect their property since their actions impact their safety.
  3. Government assistance can be more effective if it's tied to things outside a person's control, like race or family status, rather than just income. This way, people are still encouraged to work hard because their benefits don’t change based on their work efforts.

Elevance and other for-profit insurers find new scrutiny from lawmakers over their denials of care for Medicaid patients

HEALTH CARE un-covered • 419 implied HN points • 17 Aug 23
🏥 Health Politics Insurance
  1. Elevance and other for-profit insurers are denying many care requests for Medicaid patients. In fact, Elevance has a denial rate over 34%, which is really high.
  2. Lawmakers are starting to investigate these denial practices more closely. Congress is looking into how insurers use 'prior authorization' to say no to needed treatments.
  3. In Ohio, Elevance is having contract disputes with hospitals, impacting Medicaid patients' access to care. This means patients might struggle to find alternative hospitals that will cover their treatments.

$335 million take-home: here are the 7 health insurance CEOs who made it big in 2022

HEALTH CARE un-covered • 559 implied HN points • 01 Jun 23
🏥 Health Politics Insurance
  1. Seven health insurance CEOs made a whopping $335 million in 2022, which is 18% more than the previous record. Most of their earnings came from big stock buybacks by their companies.
  2. Molina's CEO earned more than half of the total amount, making $181 million, while the smallest companies made most of their money from taxpayer-funded programs like Medicaid.
  3. The increase in CEO pay is concerning, especially since it has happened while many Americans struggle with high medical costs and debts, indicating a focus on profits over patient care.
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UnitedHealth Group's Q2 2023 earnings report shows billion dollar gains in pharmacy benefit business, tax-funded programs

HEALTH CARE un-covered • 459 implied HN points • 17 Jul 23
💰 Finance Insurance
  1. UnitedHealth Group reported a big increase in revenue and profits, mainly from its pharmacy benefit business and taxpayer-funded programs. They made over $12 billion more than last year.
  2. The company saw significant growth in its Medicare and Medicaid programs, with enrollment in these government programs increasing faster than in traditional commercial plans.
  3. UnitedHealth's Optum division, which provides healthcare services, is growing rapidly, allowing the company to manage costs better and avoid paying out more in claims.

2022 Fairfax Letter Highlights

Tidefall Notes • 314 implied HN points • 11 Mar 23
💰 Finance Insurance
  1. Fairfax has undergone a significant transformation and is gaining more attention from investors.
  2. Fairfax's bond portfolio strategy has helped maintain its book value amidst market challenges.
  3. Prem Watsa's positive outlook for Fairfax's cash generation and potential growth in earnings is highlighted.

Walgreens said to be courting a former Cigna/Express Scripts executive to turn the company around

HEALTH CARE un-covered • 299 implied HN points • 03 Oct 23
🏥 Health Politics Insurance
  1. Walgreens is interested in hiring a former executive from Cigna/Express Scripts to help improve its business. They want someone with experience in pharmacy benefits to boost their competitiveness.
  2. Cigna has been fined $172 million for misleading the government about patient diagnoses in their Medicare Advantage program. They were accused of inflating seriousness of conditions to receive more funding.
  3. The pharmacy benefit management market is controlled by a few big companies, and Walgreens needs to strengthen its position to compete effectively against other large players like CVS and Amazon.

Amid Congressional PBM scrutiny, CVS/Aetna CFO assures investors of continued profits, even at expense of employers and taxpayers

HEALTH CARE un-covered • 479 implied HN points • 08 Jun 23
🇺🇸 U.S. Politics Insurance
  1. CVS's Chief Financial Officer stated that the company will continue to find ways to profit even if regulations change. They seem more focused on profits than helping people with their healthcare needs.
  2. Pharmacy Benefit Managers (PBMs) like CVS's Caremark are very profitable, and they control a major part of the market. This has sparked concern among lawmakers about the fairness of their practices.
  3. The current healthcare system allows companies to prioritize profits over patients, leading to higher costs and medical debt for many Americans. Lawmakers need to take action to protect the public.

Top Links 622 Trump's big choices. President-Fed interactions. Lifting the wind siege & how reinsurance trimmed its wildfire exposure.

Chartbook • 314 implied HN points • 18 Jan 25
🇺🇸 U.S. Politics Insurance
  1. High tariffs imposed by Donald Trump can be seen positively by some who believe it helps protect American jobs.
  2. Interactions between the President and the Federal Reserve are crucial for understanding economic policies.
  3. Reinsurance companies are finding ways to reduce their risks from wildfires, showing how the industry is adapting to climate challenges.

BIG INSURANCE 2022: Revenues reached $1.25 trillion thanks to sucking billions out of the pharmacy supply chain – and taxpayers' pockets

HEALTH CARE un-covered • 539 implied HN points • 27 Feb 23
🏥 Health Politics Insurance
  1. Big insurance companies made a lot of money in 2022, reaching $1.25 trillion in revenue. They mainly got this money from managing drug benefits and government health programs.
  2. Pharmacy Benefit Managers (PBMs) are becoming really important for these insurers, as they now make up a huge portion of their profits. They control a lot of the drug pricing and decide which pharmacies patients can use.
  3. Most growth for these companies is coming from government programs like Medicare, while their commercial insurance business is struggling. Many people are now finding it harder to afford their healthcare costs.

Bonds bail us out

Known Unknowns • 235 implied HN points • 26 Jun 23
💰 Finance Insurance
  1. Bonds can be a good financial tool for managing risk and long-term investment.
  2. Questioning traditional financial theories, like investing in long-term bonds, can lead to insights on managing pension funds.
  3. Work-from-home trends may not be sustainable in the long term due to the importance of workplace relationships and culture.

What is Your Life Worth?

Economic Forces • 9 implied HN points • 22 Jan 26
💼 Business Insurance
  1. People reveal how much they value life through choices like buying insurance, spending on health, and taking risky jobs, and economists use those choices to compute a "statistical value of life" (e.g., via wage premia).
  2. Empirical estimates place the statistical value of life in the millions of dollars and show it rising over time; as incomes and life expectancy rise, people tend to demand and pay more for safety.
  3. Price theory lets us put dollar values on non-market goods, so up-to-date value-of-life estimates are essential for sensible policy and cost–benefit decisions about safety and regulation.

The choice between traditional Medicare and Medicare Advantage? It’s easier than you think.

HEALTH CARE un-covered • 499 implied HN points • 16 Feb 23
🏥 Health Politics Insurance
  1. Traditional Medicare lets you see almost any doctor or hospital in the U.S., while Medicare Advantage usually limits you to a specific network of providers.
  2. Medicare Advantage plans sometimes deny necessary care, while traditional Medicare generally ensures full coverage for services recommended by your doctor.
  3. You might save money with Medicare Advantage in the short term, but if you need expensive care later, it could cost you much more than traditional Medicare.

The Big Seven health insurers spent $26.2 billion buying back their own stocks in 2022 to enrich CEOs, shareholders

HEALTH CARE un-covered • 419 implied HN points • 06 Mar 23
🏥 Health Politics Insurance
  1. The Big Seven health insurers spent $26.2 billion on buying back their stocks in just one year, which mostly benefited wealthy shareholders and CEOs.
  2. Despite making over $69 billion in profits in 2022, many Americans are struggling with high medical debt due to high-deductible insurance plans.
  3. Instead of helping patients, the focus remains on increasing share prices, leading to calls for legislation that could tax stock buybacks and support patients with their medical expenses.

When Insurance Admits AI is Safer Than People

Tippets by Taps • 6 implied HN points • 22 Jan 26
💼 Business Insurance
  1. Insurance companies are starting to price self-driving miles as much safer than human-driven miles, with some cutting per-mile premiums by about half when autonomous mode is engaged.
  2. Insurers that use onboard telemetry and AI to price risk get a strong first-mover advantage. If their lower loss rates hold, traditional underwriting based on age or ZIP will look obsolete and others will follow.
  3. As AI and robotics replace human tasks, adjacent industries, regulations, and pricing models will need to reprice reality. That shift could make cars without meaningful autonomy relatively more costly to own and be slowed by laws that restrict telemetry-based pricing.

Is the Fed Financing the FDIC?

Without Warning • 176 implied HN points • 04 Sep 23
💰 Finance Insurance
  1. The FDIC is primarily funded by banking industry fees, not congressional appropriation.
  2. During the Global Financial Crisis, the FDIC did not borrow money from the Fed but instead used clever financial maneuvers like prepayments to maintain liquidity.
  3. The FDIC may be utilizing the Fed's loans as a form of financing, with evidence suggesting that FDIC guarantees are used to back these loans, allowing for liquidity creation.

#38: Insurance isn't bought anymore. It's granted!

OSS.fund Newsletter • 18 implied HN points • 28 Nov 25
💼 Business Insurance
  1. Insurance is becoming harder to get because many companies have outdated systems that are too risky. This makes it tough for businesses to secure adequate coverage.
  2. Insurers are also backing away from covering AI-related risks due to the uncertainty and complexity involved. This leaves companies feeling exposed when using AI.
  3. To navigate these challenges, businesses need to focus on strong governance practices. This includes having clear policies and safeguards in place to protect against potential liabilities.

Doctors and patients raise alarm about prior authorization

HEALTH CARE un-covered • 319 implied HN points • 01 Feb 23
🏥 Health Politics Insurance
  1. Prior authorization can cause major problems for patients, leading to delays or denials of necessary treatments. This can sometimes result in serious health issues or even death.
  2. A lot of doctors believe that the prior authorization process actually worsens care for patients. Most doctors say these requirements can make patients abandon their treatment plans.
  3. Insurance companies aren't really cooperating with doctors to fix these issues. This makes it hard for patients to access the care they really need.

The American Health Care System is on the Brink of Collapse: How the Center for Health & Democracy Will Help Us Fix It

HEALTH CARE un-covered • 319 implied HN points • 31 Jan 23
🏥 Health Politics Insurance
  1. The American healthcare system is failing, with many people struggling to get the care they need while insurance companies make huge profits.
  2. The Center for Health & Democracy aims to expose issues in the insurance industry and work for meaningful reforms to help improve healthcare access and affordability.
  3. Many Americans are dealing with high medical costs and debt, and there is a growing need for significant changes to ensure everyone gets proper healthcare without financial burden.

Big Insurance in-fighting: why it's so important that Cigna is suing CVS

HEALTH CARE un-covered • 319 implied HN points • 30 Jan 23
🏥 Health Politics Insurance
  1. Cigna is suing CVS to stop them from hiring a former executive, citing a non-compete agreement. This shows how competitive the big insurance companies are over valuable staff.
  2. Pharmacy benefit managers (PBMs) are key players in health insurance, making more money than some health plans. They act as middlemen between patients and drug companies, but their operations are often unclear.
  3. Both political parties are focusing on reforming PBMs because they're seen as raising drug costs. There's growing legal pressure and proposed bills aimed at improving transparency and fairness in their practices.

Welcome to HEALTH CARE un-covered (formerly Wendell Potter NOW)

HEALTH CARE un-covered • 319 implied HN points • 27 Jan 23
🏥 Health Politics Insurance
  1. Many patients are struggling with high medical costs and debt, making it hard for them to get the care they need. Even those with insurance often end up underinsured and facing high out-of-pocket expenses.
  2. Big insurance companies are reporting record profits while many people still lack proper coverage or are pushed into bankruptcy due to healthcare costs. This shows a big gap in the current healthcare system.
  3. There's a push for more transparency in healthcare costs and a call for reforms to create a fairer system. The aim is to educate both the public and lawmakers about the issues and to find better solutions together.

State Farm & Jake From State Farm on TikTok

Good TikTok Creative • 58 implied HN points • 09 Feb 24
💼 Business Insurance
  1. State Farm has been successful in leveraging TikTok for marketing their brand and Jake from State Farm as a character.
  2. State Farm created a campaign around a fake film called "Agent State Farm" for the Super Bowl, starring Arnold Schwarzenegger and Jake from State Farm.
  3. By utilizing TikTok, State Farm has managed to create engaging content and build brand consideration among consumers in a competitive insurance market.

Open Letter to Insurance Companies re: BMI-Based Incentives/Penalties

Weight and Healthcare • 339 implied HN points • 27 Jul 22
🏥 Health Politics Insurance
  1. Charging more for health insurance based on metrics like BMI can create financial inequalities and harm marginalized groups.
  2. BMI is not an accurate measure of health as people with the same BMI can have different health statuses.
  3. BMI-based incentives/penalties can potentially decrease health, disproportionately affecting People of Color and those with lower socioeconomic status.

What Hasn’t Been Tried Yet in Medical Tourism

Hard Pivot • 117 implied HN points • 23 Mar 23
💼 Business Insurance
  1. Building an audience first can be a unique approach in medical tourism.
  2. Vertically integrating by owning clinics and hospitals could make sense in this industry.
  3. Unlocking new forms of supply, like tapping into patient-to-patient networks, could bring value in medical tourism.

UnitedHealth, CVS/Aetna, Cigna pulled in close to a trillion dollars last year, mostly as drug middlemen

HEALTH CARE un-covered • 279 implied HN points • 09 Feb 23
🏥 Health Politics Insurance
  1. Three major companies, UnitedHealth, CVS/Aetna, and Cigna, are now making most of their money from being middlemen in the prescription drug market rather than from selling health insurance. This means they control a big part of how much patients pay for their medications.
  2. In 2022, these companies earned over $492 billion from their pharmacy benefit management (PBM) services, showing that this part of their business is growing much faster than their health insurance offerings.
  3. These companies are expanding into primary care services, like buying healthcare centers, as they face slower growth in their health insurance segments. This shift suggests they are looking for new ways to make profits amid tougher competition.

Decentralizing the Insurance Industry

DeFi Education • 739 implied HN points • 23 Sep 21
🔮 Crypto Insurance
  1. Smart contracts can make insurance claims faster and cheaper by cutting out unnecessary overhead costs.
  2. The insurance industry has huge operational costs estimated around $900 billion, and smart contracts could reduce these significantly.
  3. Decentralizing insurance through technology is still new, which means there's a big opportunity for growth and change in the market.

Nexus Mutual the Crypto Insurance Project (Part 1)

DeFi Education • 719 implied HN points • 26 Sep 21
🔮 Crypto Insurance
  1. Nexus Mutual is a project focused on providing insurance in the cryptocurrency space. It aims to lower the high costs typically associated with traditional insurance agencies.
  2. As more big investors get involved in cryptocurrencies, insurance could become very important for scaling those investments.
  3. The article promises to explore how Nexus Mutual works and its impact on the insurance industry, especially in the context of decentralized finance (DeFi).

The price of health insurance has increased 24% over the last year

HEALTH CARE un-covered • 299 implied HN points • 04 Oct 22
🏥 Health Politics Insurance
  1. Health insurance prices went up by 24% over the last year, which is a much bigger increase than most other expenses like food or gas.
  2. While the cost of medical services only rose by around 5.6%, health insurance continues to climb, indicating issues with insurers' pricing.
  3. Deductibles and out-of-pocket costs have also significantly increased, and future premium hikes are expected, putting more financial pressure on families.

WEEKLY BRIEFLY NOTED: For 2025-01-13 Mo

Brad DeLong's Grasping Reality • 115 implied HN points • 13 Jan 25
💰 Finance Insurance
  1. Understanding Economic Issues: The text discusses the idea that many problems in society are linked to economic misunderstandings and a lack of effective communication in the management of public services. It highlights the need for better systems to gather and process information for effective governance.
  2. The Role of Government: It emphasizes that a government's primary job isn't just to keep people safe, but to empower them and solve crises effectively. Officials should focus on actual disaster management rather than just maintaining the appearance of control.
  3. Challenges of Modern Technology: There is a critique of how tech companies like Facebook are operating without a long-term vision, which affects user experiences negatively. The discussion invites us to think about how technology can be used to improve our understanding and utilization of information.

What I'm Reading: Cigna's 2022 earnings; ProPublica's prior authorization series

HEALTH CARE un-covered • 199 implied HN points • 03 Feb 23
🏥 Health Politics Insurance
  1. Insurance companies like Cigna are making a lot of money by acting as middlemen in the drug supply chain, especially after acquiring pharmacy benefit managers.
  2. Cigna's profits increased significantly in 2022, partly because they paid out less for medical claims compared to previous years.
  3. Instead of lowering costs for customers, Cigna is using its profits to buy back its own stock, which primarily benefits shareholders.

Investing in Insurance Today

Equal Ventures • 79 implied HN points • 05 Jun 23
💰 Finance Insurance
  1. Insurtech investments experienced a hype cycle: Surge in investments followed by multiples collapsing causing pain and caution among investors
  2. Disruption of legacy insurers by new entrants is challenging: Product innovation made purchase easier, but companies need to be profitable, not just innovative
  3. Digital transformation in insurance sector is valuable: Tech-enabled ecosystem enablers creating value, while legacy insurers are seeking digital capabilities

A decade-long look at how Big Insurance profiteers American taxpayers and the sick.

HEALTH CARE un-covered • 399 implied HN points • 04 Apr 22
🏥 Health Politics Insurance
  1. Big insurance companies have grown a lot in size and profit over the last decade, primarily through mergers and getting more government contracts. They now make a lot of money, with profits reaching over $60 billion last year.
  2. Most of the increase in people under these insurance companies comes from government programs like Medicare and Medicaid, not from private insurance. Taxpayers are indirectly supporting these companies even if they don't use their plans.
  3. Insurance companies are shifting more costs onto patients, leading to higher out-of-pocket expenses and making it hard for many to afford care. This is resulting in more people being underinsured and potentially struggling with medical debt.

NYC's call to move retirees to a Medicare Advantage plan is being opposed by a 9/11 hero. She's backed by hundreds of retirees.

HEALTH CARE un-covered • 199 implied HN points • 17 Jan 23
🏥 Health Politics Insurance
  1. A retired EMT, Marianne Pizzitola, is fighting against NYC's plan to move retirees to a Medicare Advantage plan. This change could hurt many retirees and reduce their healthcare coverage.
  2. Retirees are concerned that Medicare Advantage plans may limit the care they receive. These plans can require approvals for necessary treatments, which can delay or deny important medical care.
  3. The fight against the Medicare Advantage plan is uniting many retirees from different backgrounds and political views. They all agree that retirees deserve better healthcare options and shouldn't be forced into a plan that may not serve their needs.

The majority of big insurers' health plan revenues are subsidized by American taxpayers

HEALTH CARE un-covered • 279 implied HN points • 07 Sep 22
🏥 Health Politics Insurance
  1. Most big health insurers, like UnitedHealth, get a large part of their money from taxpayer funds, not from private customers. This shows how our tax dollars support these companies.
  2. Many insurers focus on getting more Medicare Advantage enrollments because the government pays them good money for it. This has become a major source of profit for them.
  3. Despite receiving big subsidies, many people using ACA marketplace plans still face high out-of-pocket costs, making them effectively under-insured. This means they might struggle to afford healthcare even with insurance.

As health insurance premiums and out-of-pocket obligations increase, so does the number of Americans who are “functionally uninsured”

HEALTH CARE un-covered • 239 implied HN points • 03 Nov 22
🏥 Health Politics Insurance
  1. Health insurance costs are rising quickly, with family premiums increasing by 43% over the last decade. This makes healthcare harder to afford for many families.
  2. More people have to pay larger out-of-pocket expenses before their insurance starts helping. On average, these costs have gone up by 61% in the past 10 years.
  3. Small businesses struggle the most with these high costs and many are no longer offering health insurance benefits to their employees, leaving more people without proper coverage.

The Equal Ventures Insurance Index - Q4 2023

Equal Ventures • 39 implied HN points • 30 Jan 24
💰 Finance Insurance
  1. Insurtech indices outperformed legacy peers in Q4 2023, showing strong recovery throughout 2023 but still below 2021 highs.
  2. Legacy brokers faced challenges in Q4 with tougher revenue growth comps, while insurtech companies in distribution & marketing excelled.
  3. P&C carriers had a positive Q4, demonstrating improved profitability expectations with lower combined ratios, notable improvements in personal lines carriers.