Aetna Delivers a Blow to ObamaCare

Health insurer says it's losing lots of money, may be forced out of ACA's insurance exchanges
By Newser Editors and Wire Services
Posted Aug 16, 2016 6:40 AM CDT
In this Aug. 19, 2014, file photo, a pedestrian walks past a sign for health insurer Aetna at the company's headquarters in Hartford, Conn.   (Jessica Hill)

(Newser) – Aetna became the latest health insurer to cast doubt upon its future in the Affordable Care Act's insurance exchanges after it called off a planned expansion on Tuesday and suggested it could abandon that market completely, the AP reports. A departure by Aetna, the nation's third-largest insurer, could further reduce the number of choices for customers and eventually push insurance prices higher. Competition by insurers is a key feature of the exchanges, designed to keep a lid on prices, but several insurers are abandoning them because they're losing enormous amounts of money. Aetna said it's been swamped with higher-than-expected costs, particularly from pricey specialty drugs, and will take a hard look at its current presence on exchanges in 15 states. When asked by the AP whether that meant Aetna might leave the exchanges entirely or just some markets in 2017, CEO Mark Bertolini said, "All of the above."

Major insurers like UnitedHealth Group and Humana have already said they're scaling back their exchange participation in 2017, and several smaller, nonprofit insurance cooperatives are winding down business after losing millions. The exchanges have helped millions of people gain health coverage, many with assistance from income-based tax credits. But insurers say this relatively small slice of their business has led to large losses because claims have been higher than expected and they're getting less government help than they thought, among other issues. Aetna said Tuesday it expects to lose $300 million this year from individual coverage it sells on the exchanges, or triple what it lost last year. Earlier this year, Aetna had said it hoped to break even in 2016. Aetna's exchange problems didn't prevent it from topping second-quarter earnings expectations. The insurer said Tuesday that its profit grew 9% to $790.8 million. (Read more Aetna stories.)

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