If they decide to enroll directly from Aetna off of the exchange, they won’t be eligible for financial assistance.
Advertisement
Aetna said in an e-mailed statement Wednesday that its worsening finances – not an attempt to retaliate because of the Justice Department lawsuit – caused it to pull out of the Obamacare markets. A month later, he again said Aetna planned to participate in ACA exchanges.
Next year, Aetna will stop offering health insurance on the Affordable Care Act’s public exchanges in Florida and ten other states. Those customers represent about 4 percent of the 216,000 residents covered through the exchange, according to the state insurance agency. The Obama administration blocked their proposed merger with Humana, so now they’re going to exit Obamacare. That was before Aetna announced its changes.
One in five manufacturers in NY said they were reducing the number of their employees due to Obamacare, according to a survey from the Federal Reserve Bank of NY.
The move leaves Floridians with fewer choices and increasing rates.
Another state-Alaska-is facing the same dilemma, with Premera being the only remaining carrier in its health exchange.
But Aetna might have just bitten off more than they meant to. But insurers say this relatively small slice of business has generated huge losses since they started paying claims in 2014.
More healthy people signing up is expected to balance the marketplace. Next year it will offer coverage in only four states.
Off-exchange plans still have to meet the Essential Health Benefit requirements in ACA, such as mental health, substance abuse, emergency and prescription drug coverage. It will only sell individual plans in Delaware, Iowa, Nebraska and Virginia next year.
While insurers like Aetna and UnitedHealth are scaling back their exchange participation, competitors like Cigna and Molina Healthcare are expanding. The Long Beach, Calif., insurer sells coverage on exchanges in nine states and was considering adding two more for next year.
In this letter, Bertollini says its all about finances: that the company was losing money on the marketplaces, and needed a financial boost from the marketplaces in order to continue to sustain those losses.
“Without getting into the heads of Aetna’s executives, it’s hard to say whether they were just describing a financial fact that they would have to pull out of the ACA marketplaces if the merger were blocked, or if they were making a thinly veiled threat”, Larry Levitt, a senior vice president at the Kaiser Family Foundation wrote in an e-mail.
“That deterioration, and not the DOJ challenge to our Humana transaction, is ultimately what drove us to announce the narrowing of our public exchange presence for the 2017 plan year”, Aetna said.
Even Aetna hasn’t given up on this business.
Aetna said earlier this month it was canceling expansion plans for its exchange business in 2017.
Advertisement
The fourth year of sign-ups for coverage through HealthCare.gov begins November 1.
