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Some things to know about Aetna’s ACA threats

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Herewith Becker’s  Hospital  Review looks at “things to know” about Aetna’s plan to withdraw from most Affordable Care Act  state insurance marketplaces:

1. The insurer warned the U. S. Department of Justice on July 5 that it would immediately act to reduce its 2017 ACA exchange footprint if the DOJ sued to stop  its acquisition of Humana.

2. Aetna CEO Mark Bertolini said if its transaction with Humana is blocked, it is “very likely”  that Aetna would exit the ACA exchanges entirely. However, if the deal closes, Mr. Bertolini said, Aetna would look into how it can support “more public exchange coverage over the next few years.”

3. On July 21, the DOJ sued to block the $37 billion Aetna-Humana deal over antitrust concerns. The DOJ is also fighting a merger between Anthem and Cigna.

4. On Aug. 15, in Becker’s words: “Aetna said it will pull out of 11 of its 15 state ACA exchanges next year, citing $430 million in losses on its individual plans since January 2014.”

5. Kevin Counihan, director of the ACA marketplaces, told Politico  that Aetna’s departure placed a greater urgency on HHS’s insurer recruitment. He asserted that losing big insurers like Aetna does not mean the exchanges are broken, but rather it is “the nature of the industry.”

6. Aetna had revenue of $15.95 billion in the second quarter of 2016, up 5 percent from the year-earlier period. The insurer recorded net income of $790.8 million, up from the year-earlier  $731.8 million.

To read the Becker’s article, please hit this link.

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