Aetna threatened to leave ACA exchanges if Humana merger was blocked

Health insurer Aetna warned the U.S. Department of Justice in July it would take immediate action to limit its presence on Affordable Care Act exchanges if the U.S. Department of Justice sued to block its pending deal with Humana, The Wall Street Journal reported. 

The Hartford, Conn.-based insurer warned about its departure in a July 5 letter to the DOJ signed by CEO Mark Bertolini. The letter stated if the DOJ challenged Aetna's $37 billion acquisition of Louisville, Ky.-based Humana, Aetna would not expand in 20 state exchanges and limit its presence to no more than 10 states. In addition, Aetna said if the deal is blocked, "it is very likely that we would need to leave the public exchange business entirely and plan for additional business efficiencies."

The threat materialized Monday when 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. The insurer will exit 536 counties.

In the letter to the DOJ, Aetna said it supports the ACA's goal, but an antitrust lawsuit or a successful block of its deal would financially strain the insurer.

"Our customers expect us to keep their insurance products affordable and continually improving, and our shareholders expect that we will generate a market return on invested capital for them," the letter stated.

If the deal closes, Mr. Bertolini said Aetna would explore its role in "supporting even more public exchange coverage over the next few years." Trial proceedings over the Aetna-Humana deal are set to begin Dec. 5 with a planned mid-January ruling. 

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