comscore Insurer Aetna pulls Obamacare plans from all but 4 states | Honolulu Star-Advertiser
Business Breaking | Top News

Insurer Aetna pulls Obamacare plans from all but 4 states


    A pedestrian walked past a sign for Aetna Inc. in Aug. 2014, at the company headquarters in Hartford, Conn. Aetna became the latest health insurer to chop its participation in the Affordable Care Act’s public exchanges when it trims its presence to four states for 2017, from 15 this year.

Aetna has become the latest health insurer to retreat from the Affordable Care Act’s public exchanges by announcing a pullback that will further deplete customer choices in many pockets of the country.

The nation’s third largest insurer says it plans to leave nearly 70 percent of the counties in which it currently sells coverage as it trims exchange participation to four states in 2017, down from 15 this year. The insurer’s late Monday announcement comes after UnitedHealth and Humana detailed their own exchange pull backs for 2017 and after more than a dozen nonprofit insurance co-ops have shut down in the past couple years.

Dwindling exchange participation from insurers is becoming a concern because competition is supposed to help control insurance price increases, and many carriers have already announced plans to seek price hikes of around 10 percent or more for 2017. Some states like Alaska and Oklahoma will be left with only one participant selling individual coverage in 2017.

Urban markets or places with higher populations should still have plenty of health insurance choices on their exchanges for 2017, said Sabrina Corlette, a research professor with the Georgetown Health Policy Institute. But that may not be the case in many rural markets.

They can be less attractive to insurers because there are fewer customers over which an insurer can spread costs, and hospitals and other health care providers can build dominating market positions, making them formidable negotiating foes over rates.

Health insurers have been finalizing their exchange plans over the past several weeks, ahead of the Nov. 1 start of enrollment for 2017 coverage.

Corlette said it may still make take a few more years for insurer exchange participation to settle out, and the government may have to step in to tweak the market for insurers, “but I don’t think the market places are crashing and burning by any means.”

The affordable Care Act, also known as ObamaCare, was signed into law by President Obama on March 23, 2010.

Aetna had said earlier this month it was canceling expansion plans for its exchange business in 2017, and it promised a hard look at its current participation. The company covered about 838,000 people through the individual exchanges at the end of the second quarter.

The cuts mean it will sell coverage on exchanges in 242 counties next year, down from 778. The Hartford, Connecticut-based insurer will sell on exchanges in Delaware, Iowa, Nebraska and Virginia next year.

The exchanges have helped millions of people gain health coverage, most with help from income-based tax credits. But insurers say this relatively small slice of business has generated huge losses since they started paying claims in 2014. Insurers have struggled to enroll enough healthy people to balance the claims they pay from high-cost customers, and they have complained about steep shortfalls in support from government programs designed to help them.

The nation’s largest insurer, UnitedHealth Group Inc., had expanded rapidly into the public exchanges and sold coverage in 34 states this year. But it only plans to offer policies in three states next year, Nevada, Virginia and New York.

Aetna has said it has been swamped with higher than expected costs, particularly from pricey specialty drugs. The nation’s third-largest insurer said a second-quarter pre-tax loss of $200 million from its individual insurance coverage helped it decide to limit exposure to the exchanges.

Aetna hasn’t ruled out a future expansion on the exchanges “should there be meaningful exchange-related policy improvements,” Chairman and CEO Mark Bertolini said in a statement.

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

“Aetna’s decision to alter its Marketplace participation does not change the fundamental fact that the Health Insurance Marketplace will continue to bring quality coverage to millions of Americans next year and every year after that,” said Kevin Counihan, CEO of the federal exchange operator, in an emailed statement.

Some insurers are expanding on the exchanges.

Cigna Corp., which offers coverage in seven states, plans to add some new markets next year. Those include Chicago, Raleigh, North Carolina, and Northern Virginia.

Molina HealthCare also is expanding its business, and Health Care Service Corp., which sells Blue Cross-Blue Shield coverage on exchanges in four states, will add New Mexico in 2017.

Insurers like Molina that have reported success so far on the exchanges say they have focused on covering low-income customers in markets where they already have an established presence in Medicaid, the state-federal program that covers the poor.

But even Molina has scaled back its growth plans. The Long Beach, California, insurer sells coverage on exchanges in nine states and was considering adding two more for next year. But it decided instead to add counties in states where they already have a presence.

Click here to see our full coverage of the coronavirus outbreak. Submit your coronavirus news tip.

Be the first to know
Get web push notifications from Star-Advertiser when the next breaking story happens — it's FREE! You just need a supported web browser.
Subscribe for this feature
Comments (47)

By participating in online discussions you acknowledge that you have agreed to the Terms of Service. An insightful discussion of ideas and viewpoints is encouraged, but comments must be civil and in good taste, with no personal attacks. If your comments are inappropriate, you may be banned from posting. Report comments if you believe they do not follow our guidelines.

Having trouble with comments? Learn more here.

Leave a Reply

  • It’s always impressive how little these politicians know about what they imagine they can design, but the sad thing is how much they screw things up in the process.

    • I bet you have a great job that has full coverage…unlike the disadvantaged who need help. Get off you high horse and stop whining about keeping up with the ‘Jones.’ You sound like a TRUMPER!

      • Jobs with “coverage”, or whatever kind of benefits, don’t fall from the sky. They are earned through hard work and sacrifice. As for being a “Trumper”, whether one supports him or not is not the issue. He had nothing to do with Obamacare. The issue is cost. And Obama can’t blame this one on Bush.

        • Don’t start selling “personal responsibility”. It doesn’t go over well here. 😉

        • You are not going to get through to someone like Dawg, who knows nothing but lashing out. He is not smart enough to get it. Probably didn’t do well in school and is angry with how his life is turning out.

      • Anyone still supportive of the ACA in it’s current configuration is either blindly obedient to partisan politics or flatly refusing to understand reality. Unfulfilled promises made with either good intentions or deceptive ones still remain unfulfilled.

        • Well I have always favored a single pay system like Canada or the US. (Medicare or US Military). Didn’t support Nixon care during the seventies so was not a big supporter today. Shame republicans offer nothing today, just pay pay pay.

        • Re Boots:

          I agree that Canada is a good example to look at.

          It is seamless and simple. There are no gold/bronze etc etc complications. There are no deductables.
          It makes Obama Care look like a Rube Goldberg nightmare. (Not that what we had before was not itself arcane and confusing.)

          It is mostly paid for out of tax revenue, so there is no need for monsters like the “individual mandate”.

          However, I am not sure the exact Canadian system would work in the US.
          But this does not mean that we can not come up with something that has its simplicity and advantages.
          One thing I like a lot is that it is run by the states (provinces), and not the IRS/feds.

          Trump once referred to the Cdn plan as one of the other approaches we could look at.
          I wish he would re-think this and explore it a little more.

        • Translation of Boots’ post:

          “I favored shooting myself in the left foot, now, finding that didn’t produce the desired effect, insist on shooting myself in the right foot”.

          Note to Boots: Less than .5% of the population serves in the military. Probably not such a good example AND they’re all young healthy people. Better example: The UK where some bureaucrat can put you on Liverpool Pathway to a cost effective, managed death or perhaps a long waiting list for hip replacement, or maybe an unexpected death due to high mortality rates for cancer and heart disease due to lack of preventive exams because they are too costly.

        • @hawaiikone, O and his Dems, 100% of them, voted for this monstrosity with zero republicans voting for it. Obamacare Architect Jonathan Gruber, who several times openly on media, said O needed stupid Americans to believe this law in order for it to pass.
          The Grubers include klastri who said Obamacare is O’s GREATEST & SIGNATURE LEGACY ACHIEVEMENT.
          Boots said…”Shame republicans offer nothing today, just pay pay pay” proves he is a true Gruber. Why cry now Boots…you guys created this STUPID law, you guys fix it.
          If Trump/Pence gets in they WILL FIX IT!

        • I agree that Canada is a good example to look at.
          There are no gold/bronze complications. There are no deductibles. The average quality of care has been found to be higher than ours.

          It is mostly paid for out of tax revenue, so there is no need for
          the mandate.

          However, I am not sure the exact same system would work in the US.
          But this does not mean that we can not come up with something that has its simplicity and advantages, and avoid its problems.
          One of these is there is no alternative.

        • Some years ago in London, one of our high school musicians got an ear infection two days before a scheduled flight to New York. The Tour Company rep made a phone call, we took him to a National Health clinic. He received excellent treatment. When we were leaving, we went to try to coordinate medical plan details. They told us not to worry about it. It’s all covered.

        • I’m confident many examples exist of excellent overseas medical care, as well as many examples in the US of miraculous procedures used to save patients previously deemed lost. The challenge comes when the two critical aspects of health care are trying to mesh..

      • Dawg, it would be nice if everybody could have access to healthcare. But it costs money, and I don’t like the Democrat way of taking other people’s money so that deadbeats, freeloaders, welfare queens can have free stuff. At least do it at a level that is respectful to the people that have to pay for it.

  • HilLIARy is so proud of the failed Obamadon’tcare that she is going to use tax dollars to prop it up if she is elected. Hawaii, let’s make sure this doesn’t happen, if you don’t like Trump, vote your conscience and vote for Jill Stein. But if you really don’t want the bleak future that HilLIARy presents, you have to vote for Trump.

    • Oh BTW Mai…….. let’s not forget. #1. That Hillary Clinton will be “Raising Taxes” approximately… 1 TRILLION DOLLARS. Because she knows how to spend YOUR money better than You! Haaaaaaaaaaaaaa!
      #2. Cutting back Taxes and putting that money back in your pocket.

      If you agree with the above #1 ,congratulate yourself ,consider yourself a Socialist.

      • Boots voting Johnson or Stein is just a “Make Believe Feel Good that I voted thing…….nothing more. Like Bernie they have NO Chance!

        round 2. round 2… Let’s Fact Check AP. You in Boots? Here goes.
        Why isn’t AP telling us the Half of those Exchanges are taking heavy losses. They are Sinking! And my Favorite. Why isn’t AP telling us the The Subsidies the Insurance Co. receives to make the ACA “Affordable”, will expire at the end of this year!IMUA

        • Voting for Johnson is the only real chance we have to make a positive direction change together. Showing support now, by poll, media, word of mouth, donation, whatever, is critical to get him on the debate stage. You know that’s the right thing to do, so do it. Once he’s on stage, he’ll really take off against the other two. Should that not happen, you’re not voting until November, so what have you got to lose?

      • You mean it’s not silly to throw your vote away on Johnson or stein? You must love Hillary, otherwise you’re going to feel real silly on Nov 9th.

      • Either you’ve had it with Washington, and want Trump in there. or you’re happy with a smart criminal keeping the status quo. Not the best options to make a selection. Were there more of us willing to stand up for a better alternative by actively supporting a good candidate, we’d at least give him the voice needed to present his case to all voters.

      • The campaigns of both Mr. Johnson and Ms Stein have some very positive aspects. They don’t have major skeletons in their closets and to a degree, speak with a voice of moderation. Unfortunately, a system of only two parties offering one-size-fits-some solutions has become so intrenched in our national psyche that it’s virtually impossible for a third or fourth party candidate to gain any political traction. Mr. Johnson, the leader of the alternative candidates still has a flat polling trend line and is at the same 8.5% that he owned in May.

        The unfortunate truth here is that If I vote for Johnson or Stein, it is equivalent to subtracting a vote from the major candidate I dislike least thus giving that vote to the candidate I dislike most. It’s not a good place to be but reality is what is and not what we would like it to be.

        • Yes, but support for Johnson doesn’t equate to a vote for him. Perhaps he may not garner sufficient numbers to even warrant debate appearances, which will be our collective loss. And even with the exposure should he indeed be included, he may not generate enough serious support, which essentially puts us right back where we are now. Don’t we deserve to at least give him a shot?

  • A few “Mantras” for your mind to ponder:lol
    To understand the ACA or Obama Care,”The key word to remember is “Affordable” Affordable ,affordable…And if you like your Doctors, you can keep them too……Another one of my Favs are,”You has to pass the Bill to know what’s inside the Bill”….by; Nancy Pelosi. Don’t you just love her!

    Approximately 13 million people are enrolled the ACA. These dismal numbers are staggering, and yet they want continue, with another enrollment, slatted for Nov,1016.? Even with half of these Exchanges across the country are taking heavy losses? Huge Losses!
    But Government officials say the Exchanges are Improving! Haaaaaaaaaaaaa! Of course they’ll say that,what do you expect?They are government officials .lol And yet,they want us to continue it? more lol
    Your “Everyday Politicians” are simply…not cutting it.This is Insane!

    Keep in mind.
    The Insurance Companies are NO fools. Even with the massive losses they suffered, they hung in there. But why , do you think they are pulling out and cutting back during this specific time ??

    Better question is; Why isn’t AP telling us, that those Subsidies which the Insurance Companies receives, to make those plans “Affordable ” for people to buy insurance? That it WILL END………
    At the END of this YEAR!
    Yeah! As my favorite Chef would say.”I tell you what”.Ya ain’t seen nothing yet. IMUA

  • Obamacare is a complete failure that gave health insurance to a tiny percentage of people who do not know how to use or respect the service, while lining the pockets of Democratic politicians and taxing heavily everyone else. Strike this stupid law down. We cannot afford more insurance companies pulling out of areas, providing no competition, and rates jumping double figures every year.

  • Obamacare = Obamafailure.
    Why are liberals so factually stupid when it comes to private sector realities?
    Nothing can be free, except gravity and the ability of the state to screw up everything it touches.
    Heath Care is no exception, it needs to be as easy as going to McDonalds and ordering a Happy Meal —-> BUT NO! The state MUST get in the way and create chaos and extraordinary expenses on top of the trauma inflicted by being human.
    How sad……………

  • Typical Insurance Company. They can’t make obscene and exorbitant profits from a captive audience, so they BAIL OUT. When will the US realize Insurance companies are THE cause for out of control Health Care Costs. Take Insurance companies out of Healthcare and suddenly the costs will plunge !!1

  • The slow motion train wreck that is Obamacare continues to hurt the people it was supposed to help. Remember the Hawaii Health Connector and the millions of taxpayer money that went into pockets of juiced-in contractors with nothing to show for it? “Government officials say the exchanges are improving and healthier people are signing up, which helps insurers balance the claims they get from sicker customers”. Nope, the exchanges are not improving and healthier people are not signing up, that’s the root of the problem.

Scroll Up