Aetna Withdraws from ACA Exchanges After Huge Losses


Aetna hopeful for a better exchange model to help uninsured individuals.

Aetna is the latest large insurer to announce withdrawal from certain Affordable Care Act individual exchanges due to significant financial losses.

This withdrawal is not a surprise to many, since earlier in the month, the company stated it would withdraw from certain exchanges; however, their absence will likely have a great impact on states where it will no longer offer plans.

In a press release, the company stated that it will reduce participation from 778 counties to just 242 for 2017. However, they will be offering an off-exchange individual plan to customers. The company said it will maintain their presence in Delaware, Iowa, Nebraska, and Virginia.

Aetna is leaving these exchanges because of financial losses and an inadequate risk adjustment program. The company cited an immense second-quarter loss of $200 million, which makes their total loss from the exchange $430 million.

Aetna is joining the likes of 40 other health insurers that have also chosen to withdraw from 1 or more markets, according to the press release.

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

The company states that a majority of co-ops have also failed in the exchanges due to financial losses. However, they remain hopeful that the Department of Health and Human Services will explore new options to create a more effective risk adjustment program, and prevent other insurers from withdrawing, as well.

Aetna said they hope to work with policymakers to help create a revised exchange model that can better serve the uninsured population.

“We are committed to a health care marketplace that gives every American the opportunity to access affordable, high-quality care,” Bertolini concluded. “We will continue to evaluate our participation in individual public exchanges while gaining additional insight from the counties where we will maintain our presence, and may expand our footprint in the future should there be meaningful exchange-related policy improvements.”

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