Aetna became the latest big insurer to pare back on providing individual health plans under the Affordable Care Act when it announced Monday it would bail out next year from 11 of the 15 states where it sells the plans.
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Aetna says it has lost more than $430 million in the individual market since January 2014.
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.
“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.
Earlier this year, Aetna signalled it would again sell policies in Pennsylvania’s marketplace in 2017, and it said it may consider participating in the exchanges sometime in the future.
In what is a major blow to Obamacare, Aetna, one of the largest providers of health insurance in the United States, is pulling out of roughly two-thirds of the exchanges through which it now provides coverage.
One of America’s biggest health insurers, Aetna, made an announcement on August 15 that it will stop its operations in nearly 70 percent of counties where it presently provides coverage under Obamacare. That insurer, Oscar, expanded to Dallas and several other states in 2016, but in 2017 plans to cut its NY network in half. In contrast, urban markets, where most people live, are expected to still have plenty of health insurance choices on their exchanges for 2017.
She added that Aetna said it just simply “did the math” and that it was too much of a financial hit for the company.
Bertolini said Aetna is encouraged that federal health officials will explore changes to the risk adjustment program.
Aetna covered about 838,000 people through the Obamacare exchange in its 15 states as of June 30, and on August 2 said it was re-evaluating its approach to the market. Insurers have struggled to enroll enough healthy people to balance the claims they pay from high-cost customers, and they have complained about steep shortfalls in support from government programs created to help them. The decision raises the prospect that some consumers will only have one insurer to choose from when they buy 2017 coverage.
The nation’s largest insurer, UnitedHealth Group Inc., had expanded rapidly into the public exchanges and sold coverage in 34 states this year. The company will continue to do business in Delaware, Virginia, Iowa and Nebraska.
The company essentially blames the exchange participants for being sicker than they expected.
Aetna also pointed out that it isn’t the only insurance company that has chose to pull out of the Obamacare exchanges.
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“This is really going to come home just before the November election, when people start to see their premium increases for next year”, Turner said.
