Aetna Inc. said it will pull out of the Affordable Care Act exchanges in Delaware and Nebraska next year, confirming that the insurer will exit all of the marketplaces where it currently sells plans.
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Earlier, Aetna announced it was leaving the exchanges in Iowa and Virginia, its other two current marketplace states. The company also said publicly that it planned on "significantly reducing" its marketplace business, which has continued to lose money even though Aetna had already sharply cut its exchange footprint in 2017 from 15 states last year.
Aetna said its individual plans are projected to lose more than $200 million this year, and "those losses are the result of marketplace structural issues that have led to co-op failures and carrier exits, and subsequent risk pool deterioration." The insurer said that "at this time [we] have completely exited the exchanges."
However, Heather Korbulic, executive director of Nevada's health-insurance marketplace, said Aetna has filed materials indicating that it will offer plans there next year. "We are anticipating their participation in the exchange for 2018," she said. "We're happy there will be more competition in the marketplace." Aetna agreed to enter the exchange as part of a contract to manage Medicaid plans in the state, she said.
An Aetna spokesman declined to comment.
According to the Kaiser Family Foundation, Aetna isn't the sole exchange insurer in any of its current regions. Other large, publicly traded insurers, including Anthem Inc., Cigna Corp. and Molina Healthcare Inc., have said they are considering pulling back from the exchange business but haven't yet made final decisions.
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Aetna's move will feed into the broader political debate over the future of the ACA, in which both Democrats and Republicans are seizing on developments in the exchanges to back their own arguments. President Donald Trump tweeted about Aetna's decision to withdraw from Virginia, saying "Death spiral!" Republicans have argued that strains in the ACA exchanges are signs of the existing law's flaws, as they seek to advance their own health-overhaul legislation.
Democrats, for their part, have said that issues with the exchanges are being exacerbated by uncertainty facing insurers under the Trump administration. The Trump administration has sent mixed signals about the future of federal cost-sharing payments that help reduce health costs for low-income ACA enrollees. Insurers have said if those payments aren't locked in, the exchanges will see withdrawals and large rate increases.
On Tuesday, the Tennessee state insurance regulator disclosed that BlueCross BlueShield of Tennessee will offer marketplace plans in the Knoxville region next year, filling a potential gap left when Humana Inc. announced it would pull out of all of the exchanges where it does business.
Other areas of the country may be at risk of having no exchange plans. Last week, Medica, a nonprofit insurer, said it was considering withdrawing from Iowa's exchange next year, a move that would likely leave much of the state with no marketplace plans, after earlier announced departures by Aetna and another insurer.
In other states with early filing deadlines, some insurers have been seeking significant rate increases for 2018, citing the health costs of enrollees as well as, in some cases, regulatory uncertainty. Anthem filed for a 33.8% average rate increase for next year's individual plans in Connecticut and 37.7% in Virginia. CareFirst BlueCross BlueShield is seeking a 52% average increase in Maryland, 35% in Virginia and 29% in the District of Columbia.
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(END) Dow Jones Newswires
May 10, 2017 19:36 ET (23:36 GMT)