Aetna pulling back from Obamacare in Pennsylvania

When Aetna announced Monday that it meant to scale back its Affordable Care Act participation, some ACA supporters began to speculate that the DOJ’s move to block the merger played a role in the insurer’s decision to withdraw from almost 70 percent of the counties where it was participating on exchanges.

A wave of health insurers have announced plans or filed paperwork to exit Arizona’s marketplace altogether or scale back offerings in some counties in 2017.

Bertolini says the company remains committed to “providing affordable, high-quality health care options to consumers”, but that it isn’t possible without a more balanced risk pool, meaning more young, healthy individuals to balance out those who may be older or sicker, and thus more expensive. Places like Pinal, a county in the Phoenix area in Arizona, could have no insurers participating on the exchange next year, as The Wall Street Journal points out. They already were the only companies offering plans statewide.

Despite reporting a “landmark year” in its 2015 annual earnings report, the publicly traded company says that it’s losing money on the online marketplaces launched in 2014 to sell health insurance plans to Americans. “While the Affordable Care Act, known as Obamacare, has brought coverage to millions, the new markets have proven volatile for some of the largest for-profit insurers”.

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.

And surveys show price is the main factor influencing most consumers’ decisions to purchase health insurance in the marketplaces.

An estimated 10 million people have signed up for Obamacare to date, less than half the amount originally expected. We now plan, as part of our strategy following the acquisition, to expand from 15 states in 2016 to 20 states in 2017. The announcement late Monday came several weeks after UnitedHealth and Humana also said they would cut their coverage plans for 2017 and after more than a dozen nonprofit insurance co-ops have shut down in the past couple of years.

Bertolini said he’s encouraged that federal health officials have pledged to consider “new options to modify the risk adjustment program”. “We have a far more stable individual, non-group market than we ever had before”, he said.

Another major health insurance company is drastically scaling back its Obamacare participation, citing unsustainable financial losses. Bertolini said in the letter that Aetna actually was planning on expanding its ACA business to 20 states next year, but Aetna announced this week that it was slashing its Obamacare presence to just four states.

“We are re-evaluating our 2017 plans and where Blue Cross Blue Shield of Arizona makes coverage available”, the statement said.