Aetna aiming to enter ACA exchanges in 4 more states

Updated Aug. 4 with additional details

Though enrollment in Aetna's initial return to the Affordable Care Act's exchanges was lower than expected, the insurer is planning to enter more states for the upcoming open enrollment.

CVS Health CEO Karen Lynch told investors on the company's earnings call Wednesday morning that Aetna is awaiting regulatory approval to add four additional states to its exchange portfolio. This will bring its total reach in the exchanges to 12 states.

"We're on track to expand coverage where we currently have individual exchange offerings," she said.

The healthcare giant later announced that one of those new states would be California, where Aetna will offer its CVS Health co-branded plans on the exchanges. The plans allow members access to Aetna's national provider network as well as a variety of low-cost services through CVS, such as at its MinuteClinics or HealthHUBs.

The plans will be available in select California counties: Sacramento County and the surrounding El Dorado, Placer, Yolo counties as well as the greater Fresno area, including Fresno, Kings and Madera counties.

"We're ensuring more Californians and Americans can get access to Aetna's quality care," said Jeff Hermosillo, California Market President at Aetna, in a statement. "We are uniquely positioned to work with the member to achieve better outcomes, across health plans, MinuteClinic, CVS HealthHUB, CVS Pharmacy or any of our virtual care options."

In addition, the company hit a milestone in Medicare Advantage membership, Lynch said, topping 2 million individual members, including duals, in the second quarter. She said that MA remains one of the company's largest growth segments, with membership expanding at a double-digit pace and faster that the market trend overall.

CVS Health beat the Street in the second quarter with $2.95 billion in profit, according to its earnings report released Wednesday morning.

That's a notable increase from the $2.8 billion in the company posted in the prior-year quarter. The healthcare giant also surpassed analysts' expectations with $80.6 billion in revenue for the quarter, Zacks Investment Research said.

In the second quarter of 2021, CVS Health brought in $72.6 billion in revenue.

Through the first half of the year, the company has earned $157.5 billion in revenue and $5.3 billion in profit, according to the report. By comparison, it raked in $141.7 billion in revenue and $5 billion in profit during the first six months of 2021.

“Despite a challenging economic environment, our differentiated business model helped drive strong results this quarter, with significant revenue growth across all of our business segments," said Lynch in a statement. "The continued success of our foundational businesses accelerated our strategy to expand access to health services and help consumers navigate to the best site of care."

At the company's Aetna subsidiary, revenues were $22.8 billion, up nearly 11% year over year thanks to growth across all of its product lines, CVS said. Through the first half of 2022, the company  boasts 24.4 million members, up by about 900,000 from the prior-year quarter.

Revenues at Caremark were up 11.7% compared to the second quarter of 2021, reaching $42.8 billion, according to the report. Pharmacy claims processed by the pharmacy benefit manager increased by 3.9% on a 30-day equivalent basis in the quarter, driven by new business and an extended cough, cold and flu season even as COVID-19 vaccinations declined.

CVS Pharmacy also saw its revenues increase year over year, according to the report, reaching $26.3 billion. Growth in the retail segment was driven primarily by increased prescription and front store volume, CVS said.

Due to the results, the company is boosting its full-year guidance to between $8.40 and $8.60 in earnings per share.