Aetna will continue to offer exchange plans in Delaware, Iowa, Nebraska and Virginia.
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The decision by Aetna is the latest blow to President Obama’s signature domestic policy law.
The company’s decision, which it blamed on heavy losses tied to the insurance plans, follows similar moves by competitors such as UnitedHealth Group, the nation’s largest insurer.
Aetna and United Healthcare have complained they’re losing money on Affordable-Care Act plans.
“Aetna’s withdrawal from almost a dozen exchanges is another sign that Obamacare is unsustainable”, FreedomWorks CEO Adam Brandon said.”Premiums are rising as a result of diminished competition and unbalanced risk pools that have led to a higher than expected utilization of health care”.
“The vast majority of payers have experienced continued financial stress within their individual public exchange business due to these forces, which also are reported to have contributed to the failure of 16 out of 23 co-ops”.
Aetna, which earlier this year said it was too soon to give up on the exchanges despite its challenges, this month signaled it was reconsidering.
Aetna, one of the top five medical insurance companies in America, will stop offering insurance plans to in states where they now provide coverage through individual exchange marketplaces, the company announced Monday. The insurer now offers plans in 15 states including Pennsylvania.
Aetna said it remains hopeful it can work with policymakers and “may expand our footprint in the future should there be meaningful exchange-related policy improvements”.
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. This has lead to an unbalanced risk pool among policyholders, and Aetna now questions the sustainability of its state-run exchanges. United Healthcare has also said it will withdraw from the OH marketplace next year. Aetna exchange plans will be available in 242 counties, down from 778 this year.
Aetna’s announcement comes as the insurer is locked in a battle with the U.S. Department of Justice over its effort to acquire Humana for $37 billion. It allows those companies to shift the insurance risk of sick, expensive ACA enrollees to newer companies and not-for-profit plans.
Losses on ACA plans have been widespread. A number of companies have said patients who visit the exchanges are older. “A lot of it has to deal with the risk pool and the size of the population they are serving”, says Trenschel.
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They can be less attractive to insurers because there are fewer customers over which an insurer can spread costs, and hospitals and other health care providers can build dominating market positions, making them formidable negotiating foes over rates.
