Aetna to Exit all ACA Insurance Marketplaces in 2018

May 2017 ~

Aetna has announced plans to completely withdraw from the ACA insurance exchanges for 2018, citing financial losses as the deciding factor, specifically its individual commercial products.

In first quarter financial results, Aetna reported a net loss of $381 million. Last year, the insurer reported a loss of $450 million on its nearly 1 million customers with individual health policies on and off the insurance exchanges last year as well as had 964,000 individual commercial plan members as of the end of 2016, but that number has since dropped to 255,000.

In a statement, Aetna attributed its losses to a combination of high numbers of new members and a larger share of members needing high-cost care “coupled with the current inadequate risk adjustment mechanism, results in substantial upward pressure on premiums and creates significant sustainability concerns” as well as “marketplace structural issues that have led to co-op failures and carrier exits, and subsequent risk pool deterioration.”

Aetna projects around $225 million in losses from its exchange plan businesses this year following a loss of $700 million for 2014 through 2016.

According to this and other recent announcements, Aetna will no longer sell individual health plans in Delaware, Nebraska, Virginia, and Iowa in 2018.

Source(s): AetnaHealthcare Finance News; Healthcare DIVE; The New York Times; The Wall Street Journal; The Washington Post; Law360;