UnitedHealth Group, the nation’s biggest health insurer, announced in April it will cut its participation in public health insurance exchanges to a few states next year after expanding to almost three dozen for this year.
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Health insurer Aetna made the national mainstream news this week and dealt a blow to the Affordable Care Act by announcing that it would stop offering individual coverage via public exchanges in 536 counties across the nation. About 11.1 million people were signed up for Obamacare plans at the end of March. Anthem Inc. has publicly said that if it is able to consummate its acquisition of Cigna Corp., a combination that is also facing a Justice Department suit, the merged company would likely expand into nine new exchange states.
From the Aetna letter: “Our analysis to date makes clear that if the deal were challenged and/or blocked we would need to take immediate actions to mitigate public exchange and ACA small group losses”.
Off-exchange plans still have to meet the Essential Health Benefit requirements in ACA, such as mental health, substance abuse, emergency and prescription drug coverage.
The departure leaves Boone, Campbell, Owen and Kenton counties with only two exchange plans. A company spokesman says a final decision on 2017 policies is pending. United Healthcare has also said it will withdraw from the OH marketplace next year.
The company said more healthy people were needed to purchase insurance through the exchanges to offset the cost of covering less healthy people. Since January of 2014 the health insurer says it has taken a pre-tax loss of $430 million its exchange business including a pre-tax loss of $200 million on exchange business in the second quarter.
A health insurer has canceled its plans to join the Affordable Care Act’s health insurance marketplace in ME, citing financial concerns.
Alabama is now one of just a handful of states with only one option in the Affordable Care Act marketplace.
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“Aetna’s decision to alter its Marketplace participation does not change the fundamental fact that the Health Insurance Marketplace will continue to bring quality coverage to millions of Americans next year and every year after that”. Dwindling insurer participation is becoming a concern, especially for rural markets, in part because competition is supposed to help control insurance price hikes, and many carriers have already announced plans to seek increases of around 10 percent or more for 2017.
