Aetna to leave 11 of 15 state ACA exchanges

Hartford, Conn.-based health insurer Aetna will pull out of 11 state Affordable Care Act exchanges next year, citing $430 million in losses on its individual plans since January 2014.

The insurer will remain in four states — Delaware, Iowa, Nebraska and Virginia — out of the 15 state exchanges it participated in this year. In total, Aetna will exit 536 counties.

The insurer said it will communicate options to members before 2017 open enrollment begins Nov. 1 and provide resources to help affected policyholders transition to different plans.  

CEO Mark Bertolini said while Aetna regrets making its decision, the departures will limit the insurer's future financial exposure. He added an unbalanced individual risk pool and a faulty risk adjustment mechanism created under the ACA has created "significant sustainability concerns" for the insurer.

Aetna said it remains hopeful it can work with policymakers and "may expand our footprint in the future should there be meaningful exchange-related policy improvements."

The decision will not affect 2016 plans. In 2017, Aetna will also offer off-exchange individual plans in a majority of the counties it offered on-exchange individual plans this year.

Aetna is the latest insurer to pull out of 2017 ACA exchanges. Minnetonka, Minn.-based UnitedHealthcare and Louisville, Ky.-based Humana said they will, for the most part, exit ACA marketplaces next year. Aetna's departure may leave at least one county — Arizona's third largest county, Pinal — with no insurers offering plans on the ACA exchange next year, The Wall Street Journal reported. 

More articles about payer issues:
Fitch: Health insurer credit metrics hit hard in first half of 2016
Study finds gaps in women's health coverage under ACA
Large companies face 6% increase in 2017 employee healthcare costs: 7 key findings

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