The company said it took a second-quarter pretax loss of $200 million and total pretax losses of more than $430 million since 2014 in individual plans. The insurer said it would stop offering policies on the public exchanges in 11 of the 15 states where it now operates, only continuing to sell Affordable Care Act products in Delaware, Iowa, Nebraska and Virginia.
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Health insurer Aetna warned the U.S. Department of Justice in July it would take immediate action to limit its presence on the Affordable Care Act exchanges if the U.S. Department of Justice sued to block its pending deal with Humana, The Wall Street Journal reported.
Insurers say they are losing too much money to stay put. Health insurance giant Aetna announced late Monday evening that they would be scaling back their Obamacare exchange offerings to a paltry four states.
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.
Soon after the Justice Department filed its suit, Anthem also tied its continued participation on the exchanges to its merger.
Officials at fast-growing CareSource, a downtown Dayton-based Medicaid managed care provider and private health insurer with operations in Ohio, Kentucky, Indiana and West Virginia, say they view the absence of Aetna and other competitors as an opportunity to grow share in the markets they abandon.
UnitedHealth Group Inc. and Humana Inc. have cited similar concerns about financial losses on the Obamacare exchanges and have also cut back most of their plans for 2017.
In New Jersey, Aetna has not sold plans on the ACA exchange, where subsidies are available. SC and most of North Carolina could join that list due to the Aetna decision, Cox noted.
Arizona Insurance Department spokesman Stephen Briggs said Tuesday that Blue Cross filings would allow it to offer Pinal County plans.
It’s true that exchanges attract mostly low-income people who likely have health issues and can only afford the lowest premiums.
“The way the law’s complicated strucutre works, the insurers need a large number of those enrollees to be young and healthy to offset losses that insurers would face on older and sicker enrollees”, said Brian Blase, a research fellow at Georgetown’s Mercatus Center. Because of that, those state marketplaces are suddenly wobbly, including in North Carolina, where the loss of Aetna and United Healthcare would leave only Blue Cross and Blue Shield selling ACA policies here in 2017.
Mark Bertolini, CEO of Aetna, told the Justice Department in July that the insurer would walk away from many health exchanges if the government opposed the company’s proposed deal for Humana.
Aetna will continue to sell coverage off the exchange.
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Of IBC’s 180,000 individual members, 70 percent have enrolled through Pennsylvania’s federally facilitated marketplace, the company said.
