Lawmakers need to pay attention to Aetna's latest decision involving ObamaCare. That's the advice of a senior health policy analyst with the Independent Women's Forum.
Aetna, the nation's third-largest health insurer, says it won't participate in ObamaCare exchanges in Nebraska and Delaware next year. The insurer had pulled out of several other states after losing nearly a half-billion dollars in 2016; this decision comes after projecting a $200 million loss this year.
Hadley Heath Manning of the Independent Women's Forum points out Aetna has been reducing its participation in state-based exchanges – and not just because of financial losses.
"They announced a while ago they wouldn't participate in Virginia's exchange, and that time they cited some of their concerns related to the current legislation under consideration that just passed the House," says Manning, IWF's director of health policy. "And of course this puts insurance companies in a difficult position because they're going to have to reconsider how they do business and what kind of plans they can offer depending on a variety of decisions that lawmakers at the federal and state level are making."
That said, when Aetna announced this week it would no longer participate in any of the exchanges, it didn't cite uncertainty related to the law, but rather financial losses the company has experienced.
"If an insurance carrier can't make money in the exchanges, then it's not in their best interest to participate," Manning adds. "We have to recognize that reality if we want to consider the best laws that are going to give consumers the most options and at the best prices."
Other insurers have said as much in recent months. Some have also been fleeing exchanges, including Humana, UnitedHealth, and even Blue Cross Blue Shield in some cases.
Over the two years, Aetna wanted to merge with Humana – and Anthem sought to merge with Cigna. Both those mergers were blocked by federal judges. OneNewsNow asked Manning if things would be different today had one or more merger been approved.
"The companies who suffered the financial losses were looking at mergers as a potential way to ward off some of their financial problems, and some people speculated that Aetna pulled out of some of the exchanges earlier as sort of revenge against the Obama administration for denying their merger request," answers Manning.
"I don't know that that's so much the case because when you're a customer, whether we have the big five or the big three or a handful of options," she continues. "It really depends on where you live and what's available to you – and when you have consolidation in the health insurance market, that's another way that consumers face fewer options."
So whether it's insurers exiting the exchanges altogether or merging with other big insurance companies, the bottom line for consumers is the trend toward fewer choices.
"And fewer choices means not only do we have fewer options in terms of plans, but our networks depend on what plans we get, our doctors are dependent on those networks, and for us it's about accessing care and the prices that we pay," Manning concludes. "The trend has been bad for consumers regardless of what would have happened with those mergers."