About 20,000 Aetna policyholders in OH will be forced to find new health coverage next year as a result of the Connecticut-based company’s decision to pull out of the Affordable Care Act’s health insurance marketplaces in certain markets across the country. While the insurer is offering plans in 15 states this year, it will offer the coverage in just four states in 2017.
Advertisement
“This is really going to be felt in Southern states and rural areas”, said Cynthia Cox, associate director of health reform and private insurance for the Kaiser Family Foundation, which studies health care issues. In the midst of that, they’ve also made a decision to cut ties with the Affordable Care Act in 68.9 percent of the counties where that health coverage is offered.
UnitedHealthcare (UNH), the nation’s largest insurer that is expecting to lose about $1 billion on Obamacare policies in 2015 and 2016, is exiting most Obamacare exchanges in 2017. In a post on her Facebook page last week, Warren questioned the company’s motives after it first hinted that it was considering cutting its participation in Obamacare.
The change in tack for Aetna is also noteworthy because Bertolini was talking up the business potential of the exchanges as recently as April, when he said during a call with analysts and investors that the exchanges were “a good investment”, despite the losses incurred.
“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.
Rural markets can be less attractive to insurers because there are fewer customers for insurers to spread costs across, and hospitals and other health care providers can build dominating market positions, making them better able to negotiate rates.
As Richard Kirsch, former National Campaign Manager of Health Care For America Now and Senior Fellow at the Roosevelt Institute, said Tuesday, “Big commercial insurance corporations continue to put profits before patients’ health, which is why Hillary Clinton’s call for a public insurance option so that everyone in every exchange in the country has a choice of an affordable option is more essential than ever”.
And despite corporate media spin on the departures, Hiltzik concluded that “it’s a mistake to view insurers’ withdrawals from ACA exchanges as a sign that it’s impossible to provide affordable health coverage to more Americans”. SC and most of North Carolina could join that list due to the Aetna decision, Cox noted.
Another health insurance company announced this week it will exit the Obamacare marketplace, a move that leaves SC customers who rely on the federal law for coverage with even fewer options next year.
Large insurers aren’t the only ones running into trouble. 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.
“I think the market will stabilize, and perhaps Aetna and United will come back”, said Jost. United Healthcare has also said it will withdraw from the OH marketplace next year.
Aetna, which had 838,000 exchange customers at the end of June, said its policyholders are turning out to be sicker and costlier than expected. It will sell coverage on exchanges in 242 counties next year, down from 778. Aetna (AET) will only sell Obamacare products in Delaware, Iowa, Nebraska and Virginia.
A spokesman for HHS said Aetna’s decision was an about-face from its earlier statements about the Obamacare exchanges.
Sabrina Corlette, a research professor with the Georgetown Health Policy Institute, said it may still take a few more years for exchange participation to settle and the government may have to change some of the market rules.
Advertisement
“This is what many of us have warned about, and for that reason voted against, in terms of unforeseen effect with regard to Obamacare”, said U.S. Rep. Mark Sanford, who was not a member of Congress when the Affordable Care Act was passed in 2010.
