There has been speculation that the insurer’s decision was a reaction to the Justice Department’s move to try to block the company’s merger with Humana.
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Then, just a couple of weeks before the Justice Department sued to stop the merger in July, Aetna warned that it would not be able to continue to offer its policies on the Affordable Care Act’s health insurance exchanges unless the merger were approved.
In October 2015, Bertolini told investors that the company’s exchange business comprised a fraction of operating revenues, presenting an “opportunity to play”, according to the senators’ letter.
He did not mention the costs incurred by the Justice Department’s denial of approval of the merger, but said the Affordable Care Act “is not sustainable without bipartisan action that improves access, affordability and quality of care for consumers”.
“Aetna’s decision regarding its participation in the ACA exchanges appears to be an effort to pressure the Justice Department into approving a merger that the Department has alleged violates antitrust law and has the potential to significantly harm consumers all across the country”, the letter says.
However, last month, the company said it lost $200 million on the exchange business in the second quarter.
In their letter, the senators noted that there was reason for the company to be wary of a possible Justice Department lawsuit and that the $1 billion merger break-up fee was a “expensive and risky bet on a highly uncertain outcome”.
The Democratic senators called Aetna’s retreat from Obamacare “inexplicable and irresponsible”.
“We are one of many insurers, large and small, that has been forced to reduce its public exchange participation due to an increasingly unstable marketplace”, Aetna said by emailed response. “Aetna could not have been surprised at the concerns raised by regulators about this merger”. This isn’t a recent development, as more than 40 companies exited certain geographies for the 2016 plan year.
They also want to know what criteria Aetna used to determine which states to withdraw from.
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BCBS has said its exchange rates are increasing close to 20 percent in 2017, after a 32 percent increase this year, WLOS reported.
