Pete Kasperowicz writes for the Washington Examiner about the insurance giant’s most recent experience with the Affordable Care Act.
Healthcare insurer Aetna announced Monday that it would reduce its participation in Obamacare by more than two-thirds, after suffering a $200 million loss in the second quarter of this year, a loss caused by too many sick people signing up for President Obama’s signature healthcare program.
“Providing affordable, high-quality health care options to consumers is not possible without a balanced risk pool,” the company said in a statement. “Fifty-five percent of our individual on-exchange membership is new in 2016, and in the second quarter we saw individuals in need of high-cost care represent an even larger share of our on-exchange population.”
“This population dynamic, coupled with the current inadequate risk adjustment mechanism, results in substantial upward pressure on premiums and creates significant sustainability concerns,” it said.
Aetna said it now operates in 778 counties across the country, but that this would be slashed to just 242 counties in 2017. After leaving the other markets, it will operate in just Delaware, Iowa, Nebraska and Virginia.
Meanwhile, from the whistling-past-the-graveyard department …
Kevin Counihan, CEO of the Obamacare marketplace, sought to downplay the company’s announcement.
“Aetna’s decision to alter its marketplace participation does not change the fundamental fact that the health insurance marketplace will continue to bring quality coverage to millions of Americans next year and every year after that,” he said. “It’s no surprise that companies are adapting at different rates to a market where they compete for business on cost and quality rather than by denying coverage to people with preexisting conditions.”
He also disputed Aetna’s conclusion that the risk pool is simply too costly for companies to bear.
