Another insurer leaves South Carolina Affordable Care market

When Aetna Inc. announced that it would withdraw from three-quarters of the states where it offers Affordable Care Act exchange plans, the move wasn’t entirely unexpected: The company had signaled its woes early this month.

Aetna has said it has been overwhelmed with higher than expected costs, particularly from expensive specialty drugs.

The problem stems from the fact that ACA plan members tend to rack up high medical bills, which the federal risk adjustment program has not fully offset – causing insurers to lose money on the exchanges.

Pinal County won’t have a company offering marketplace health insurance plans next year following the nation’s third-largest health insurer’s decision to exit public exchanges in all but four states.

UnitedHealth in April announced that it will stop selling ACA-compliant individual policies Nebraska and about two dozen other states, although it will continue selling small- and large-group policies.

As with Aetna, an increasing number of health insurers on the exchanges under Obamacare are expressing concerns over the viability of the current program as they incur big losses.

The big insurer will begin to stop offering its policies on the different exchanges of 11 of 15 states where it operates now, according to its press release issued on Monday. This summer, Eagan-based Blue Cross and Blue Shield of Minnesota announced it would stop selling individual market policies – both on and off the MNsure exchange – that now cover more than 100,000 people.

“As a strong supporter of public exchanges as a means to meet the needs of the uninsured, we regret having to make this decision”, Aetna CEO Mark Bertolini said in a statement.

Read the full Aetna statement here.

Government officials say the exchanges are improving and healthier people are signing up, which helps insurers balance the claims they get from sicker customers.

In April, Bertolini called the marketplace plans “a good investment” because it would have cost the company far more than $430 million to try to attract that many customers.

Some insurers are expanding on the exchanges.

Aetna does not now offer the policies in NY. Those include Chicago, Raleigh, North Carolina, and Northern Virginia. It also said of its wish to expand its footprint in future on the condition of exchange linked policy improvements.

To cover those patients, many insurers are requesting large premium increases for 2017, some in double digits. But it decided instead to add counties in states where they already have a presence.