“The vast majority of payers have experienced continued financial stress within their individual public exchange business”, Aetna Chief Executive Officer Mark Bertolini said in the statement.
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Aetna, one of the largest health insurers in America, announced that it will no longer be selling health insurance under Obamacare in all but four states, following losses of hundreds of millions of dollars since President Obama’s signature healthcare law passed.
According to the statement, 55 percent of Aetna’s individual on-exchange membership was new in 2016, and in the second quarter of the year individuals in need of high-cost care represented a large share of the company’s on-exchange population. Politico writes that Aetna says it has lost over $430 million since 2014 on its individual products.
The nation’s 3rd largest health insurance company, Aetna, made formal Monday its plan to severely limit its participation on the public exchange marketplaces created by the Affordable Care Act. “Aetna says it will only sell 2,017 health insurance plans through the Affordable Care Act in four states”.
Another major health insurance company is drastically scaling back its Obamacare participation, citing unsustainable financial losses. The cuts mean it will sell coverage on exchanges in 242 counties next year, down from 778. It will maintain a presence in Delaware, Iowa, Nebraska and Virginia. “Hillary Clinton outlined concrete plans to make health coverage more affordable in and out of the marketplaces, with more choices, expanded relief for costs, aggressively containing prescription-drug expenses, and the choice of a public option”, said Jesse Ferguson at the Clinton campaign.
William E Aaronson, chair of Temple University’s department of health services administration and policy, said Aetna could also be attempting to gain leverage over the government in negotiations over the Humana merger.
“We are focusing our individual on-exchange presence where we believe we are best positioned to provide access to quality care at an affordable cost”, the company said in an email.
Individual insurance companies, like Aetna, can decide to offer their coverage on the exchange in some or all states but the exchanges usually have poorer or less healthy participants.
That means no individual exchange plans in some states under the Aetna name or affiliated brands such as Coventry, a spokesman said. But United is pulling out of Arizona and Blue Cross announced in June it didn’t plan on offering coverage in Pinal or Maricopa counties next year.
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Bertko said 11 plans in California are all either making money or close to breaking even. California’s experience appears to square with accounts that smaller insurers familiar with low-income patients and offer narrow groups of physicians and hospitals are making a go on the exchanges.
