Health insurer Aetna plans to cease its participation in the Obamacare health exchanges in all but four states.
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Aetna, like UnitedHealth and Humana, cited financial losses from its individual plans as the reason for the move.
North Carolina consumers buying broadly subsidized health insurance policies on the online marketplace created by the Affordable Care Act will have fewer options after a major insurer pulls out.
Aetna Inc., the nation’s No. 3 health insurer, said late Monday it is pulling back from offering offering individual insurance plans on government-run exchanges in 2017 except in Delaware, Iowa, Nebraska and Virginia.
Premiums next year are expected to rise between 5 percent for Horizon’s Omnia plan, which had 189,000 customers this year, and 26 percent for AmeriHealth’s HMO plan, which had 14,000 members.
The company reported Monday that it lost $430 million since January 2014, when Kentucky and many other states opened their insurance exchanges.
While calling himself a “strong supporter of public exchanges as a means to meet the needs of the uninsured”, Bertolini said he regrets having to make the decision to leave the program in so many states.
Aetna’s announcement comes three weeks after the Justice Department blocked two health-insurance mergers that would have totaled $85 billion. It is this group of healthy individuals that insurers and exchange designers were hoping would offset the cost of sick patients.
Citing heavy losses tied to its low-priced insurance plans, one of the larger health insurers in the United States – Aetna Group – has announced that, beginning in 2017, it will no longer participate in the Affordable Care Act (ACA) health care program also known as Obamacare in 11 of 15 states – 242 of 778 counties nationwide.
Aetna is also trying to buy Humana and is now fighting a US government lawsuit aimed at blocking the $34 billion deal. And in five or so states, there will be only one insurer on the exchange.
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.
Aetna was the only insurer to offer plans for some parts of Arizona, which will now be without options within the Obamacare exchange. Many insurers also have sued the federal government demanding full payment from the risk-corridor program.
An estimated 10 million people have signed up for Obamacare to date – less than half the amount originally expected. To obtain the subsidies, though, people are supposed to purchase their plans through ACA exchanges.
Subsidized coverage – offered to people earning up to 400 percent of the federal poverty level (about $47,000 for an individual or $97,000 for a family of four) – is available only via the public exchanges.
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Urban markets or places with higher populations should still have plenty of health insurance choices on their exchanges for 2017, said Sabrina Corlette, a research professor with the Georgetown Health Policy Institute.
