Aetna to pull out of 11 ACA exchanges; expects losses reaching $300M: 5 things to know

Aetna will stop offering individual Affordable Care Act plans in 11 state exchanges, according to Bloomberg.

Here are five things to know:

1. This year, Aetna offered plans in 15 states. The company's latest decision to exit 11 exchanges will leave customers in North Carolina, Pennsylvania and Florida left to seek coverage elsewhere.

2. Aetna will offer plans on state changes in Iowa, Nebraska, Virginia and Delaware.

3. Aetna said it anticipated losses totaling $300 million on these state exchanges earlier this year. Similarly, UnitedHealth Group and Humana are also leaving several ACA exchanges after suffering million-dollar losses.

4. In July, Humana reported it will leave many ACA exchanges and will participate in "no more" than 11 state marketplaces.  Humana suffered $1 billion losses on ACA exchanges last year.

5. Aetna said the Department of Justice's lawsuit against its deal with Humana did not play a part in the payer's decision to leave 11 exchanges.

"The vast majority of payers have experienced continued financial stress within their individual public exchange business," Aetna Chief Executive Officer Mark Bertolini said in the statement. "Providing affordable, high-quality healthcare options to consumers is not possible without a balanced risk pool."

More articles on coding & billing:
In a race against the clock, will the Obama administration pass its Medicare payment changes? — 6 insights
CMS to update PACE program for first time in decade: 4 thoughts
Judge to decide on $37B Aetna-Humana deal in January: 5 highlights

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Webinars

Featured Whitepapers

Featured Podcast