“Our ability to withstand these losses is dependent on our achieving anticipated synergies in the Humana acquisition”, Bertolini wrote, according to a copy of the letter posted on the Huffington Post website, which obtained the document though the Freedom of Information Act.
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Also, some insurers are turning profits on the exchanges and expanding into new Obamacare markets. But the letter also pointedly said that if Aetna was not allowed to merge with Humana, then Aetna would pull out of the exchanges. “The health of the American people should not be used as a bargaining chip to force the government to bend to one giant company’s will”, she said. The nation’s third-largest insurer said a second-quarter, pre-tax loss of $200 million from its individual insurance coverage helped it decide to limit exposure to the exchanges.
For coverage this year, 87,835 Nebraskans and 55,089 Iowans enrolled in health insurance plans through the exchange, according to the Health and Human Services Department. They may already face dramatically increased premiums.
“When open enrollment occurs in November they are going to have to shop carefully…” Its bad risks and they’re losing money; to the tune of $400,000,000 if you’re Aetna [and] hundreds and hundreds of millions of dollars if you’re United [Healthcare]… if there aren’t any carriers, it’s the same thing as auto insurance.
“We’ve had a very robust enrollment under the ACA and hope consumers will still see benefits of having coverage even if they have fewer options”, said Ciara Zachary, health policy analyst for the North Carolina Justice Center’s Health Access Coalition.
There had been industry speculation that the recent change of heart on Aetna over the ACA exchanges has in part due to the decision from the DOJ to attempt to block its pending merger with Humana.
Nationwide, the company says it will shrink its presence from 778 counties to 242 next year, and will continue operating exchange plans in only four states: Nebraska, Virginia, Iowa and Vermont.
Aetna would have been the only provider selling insurance in Pinal County, Arizona, in 2017. Almost 10,000 people enrolled in Obamacare marketplace policies this year and about 85 percent received a federal subsidy.
Another big concern with Aetna’s exit is choice for patients.
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Caroline Pearson, a senior vice president at Avalere, a health-care consulting firm, said that the lawsuit may have affected the timing of Aetna’s announcement, but not the underlying facts about the viability of the marketplaces. Only Blue Cross and Blue Shield of Georgia will offer plans throughout Georgia. The letter was written while the government was still deciding whether to oppose the insurance companies’ merger on the grounds that it (and another proposed deal between Anthem and Cigna) would hurt consumers and reduce competition.
