Amid continuing financial losses on its Affordable Care Act exchange plans, Aetna CEO Mark Bertolini has announced that the company will pull back its exchange offerings from 778 counties to 242 in 2017.
Aetna lost $200 million on its ACA exchange plans in the second quarter of 2016, which combined with previous losses for a total loss of $430 million since 2014, the company says. As a result, next year Aetna will offer individual insurance products in only four states.
The insurer has not, however, indicated plans to exit the exchanges outright. Bertolini says Aetna plans to monitor utilization costs in the counties it continues to offer plans, adding the company “may expand” its footprint moving forward. In addition, he expresses “regret” over the decision given his support of the ACA.
UnitedHealth, the nation's largest health insurer, will offer plans in just three states next year. Humana has also exited a significant number of exchanges. Both have cited losses on individual insurance products.
Bertolini has previously been a voice for optimism about the exchanges. As he said in his presentation at the 2016 JP Morgan Healthcare Conference in San Francisco, “from a tactical standpoint, this is not breaking the bank one way or the other…so it’s not time to give up."
That changed earlier this month, when Bertolini announced Aetna's intent to embark upon a “complete evaluation” of the company’s exchange presence.
On a political note, Bertolini called the risk adjustment programs administered by the federal government “inadequate,” adding that “meaningful” improvements in ACA exchange policy are essential for potentially expanding Aetna's offerings in the future.
- read Aetna's announcement