In April, UnitedHealth Group, the nation’s biggest health insurer, announced it will cut its participation in public health insurance exchanges to a few states next year after expanding to almost three dozen for this year.
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“Providing affordable, high-quality health care options to consumers is not possible without a balanced risk pool”.
Some experts thought it unusual that Aetna, which had voiced support and optimism about Obamacare earlier this year, suddenly canceled its plans to expand into more states and review its participation in its current markets.
Health care company Aetna says it’s pulling its plans off the individual insurance exchanges in Georgia and 10 other states next year, making it the latest major insurer to deal a blow to President Obama’s signature health care law.
But before looking at potential solutions, it’s worth looking at what prompted the decision by Aetna – and other insurers before it – to consider backing out. 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 $37 billion deal is the subject of a lawsuit from the Justice Department.
The company said earlier it was scaling back plans to enter new marketplaces, but its announcement late Monday saw it proclaim 2017 exits in almost a dozen states with existing plans.
The company now participates in health care marketplace exchanges in 15 states.
Some insurers say they can only continue to provide care through the exchange if the federal government provides more money.
“W$3 e believe it is very likely that we would need to leave the public exchange business entirely and plan for additional business efficiencies should our deal ultimately be blocked”, Aetna CEO Mark Bertolini wrote in a July 5 letter.
Aetna is leaving exchanges in 11 states.
Yuma residents are going to have fewer options to choose from as more insurances drop Obamacare.
But Kevin Counihan, a Department of Health and Human Services official who oversees the federal marketplace, said Aetna’s decision “does not change the fundamental fact that the Health Insurance Marketplace will continue to bring quality coverage to millions of Americans next year and every year after that”.
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“I think one thing insurance companies didn’t anticipate is what good consumers we’d all be”, mit professor Jonathan Gruber said. It follows in the footsteps of UnitedHealth Group and Humana, which also announced plans to cut back their participation in the exchanges. Those numbers have since been revised upward, with insurers planning 19 percent to 122 percent premium boosts.
