Huffpost reporters Jonathan Cohn and Jeffrey Young believe they have an explanation, in the form of a July letter they surfaced from Aetna to the US Department of Justice, which is seeking to block the merger of Aetna with Humana.
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Over the past year, two merger proposals have come up from that group: one between Aetna and Humana, and another between Cigna and Anthem. No one can say for sure, but the skeptical among us suspect it’s payback.
The Department of Health & Human Services declined to comment on the letter.
Aetna announced early this week it would pull out of Affordable Care Act health insurance exchanges in close to 550 counties in 11 states, causing consternation in numerous states, particularly Texas and Arizona.
“If we were to build out 15 markets, it would cost us somewhere between $600 million to $750 million to enter those markets and build out the capabilities necessary to grow that membership”, he said on the company’s April earnings conference call with analysts.
Regardless, it appears that relying on for-profit enterprises to provide affordable insurance over subsidized marketplaces might not be the best way for a government to guarantee universal health care.
News of insurance giant Aetna pulling out of “Obamacare” was apparently not newsworthy enough for some networks.
Former Republican state lawmaker Jim Ritchie of Spartanburg is the executive director of the South Carolina Alliance of Health Plans.
Almost 1 million Aetna customers will need to find a new insurer for 2017 – a task that will prove more costly for some than for others.
The competition among health insurers in the federal exchanges was supposed to help control insurance price increases, but the few insurers who still participate have announced their plans to increase their rates for 2017 by nearly 10% or more.
Clinton, however, is silent on one of the insurers’ biggest complaints: the risk adjustment program, which serves as a backstop for insurers with high-cost patients.
The company reported Monday that it lost $430 million since January 2014, when Kentucky and many other states opened their insurance exchanges.
But Aetna might have just bitten off more than they meant to.
U.S. Rep. Jim Clyburn, D-S.C., a strong advocate of the ACA, did not respond to requests for comment.
The surprise announcement from Aetna, which blamed marketplace losses, comes at a time when plans available for county residents have already been shrinking.
“There’s obviously been a lot of attention placed on the large national carriers, but it’s also the regional carriers and co-op failures that has driven this decrease in choice as well”, Elizabeth Carpenter, a senior vice president at Avalere, said in an interview.
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Nevada, on the other hand, requires all insurers that participate in its Medicaid market to also offer coverage on its exchange. In 2017, Aetna will only offer insurance policies in 242 counties scattered across four states-that’s a almost 70-percent decrease from its 2016 offerings in 778 counties across 15 states.
