NEWS

Aetna leaving Obamacare exchange in Florida

FRANK GLUCK
FGLUCK@NEWS-PRESS.COM

Health insurance giant Aetna Inc. won’t participate in the Affordable Care Act’s public exchange in Florida during the 2016-17 sign-up period as it scales back such offerings to only four states.

Screen shot of healthcare.gov website

Aetna put much of the blame on higher-than-expected numbers of enrollees needing high-cost medical treatment. It also faulted the government’s program that provides funding to insurers treating higher rates of sick patients.

The company reported second-quarter pretax losses of $200 million in its individual-market policies, and more than $430 million since January 2014.

UnitedHealthcare leaving Florida Obamacare exchange

Aetna, which reported 838,000 Obamacare customers in June, will now only offer exchange plans in Delaware, Iowa, Nebraska and Virginia.

The company’s decision to back out of the program follows similar moves by other large insurers, including UnitedHealthcare.

"As a strong supporter of public exchanges as a means to meet the needs of the uninsured, we regret having to make this decision," Aetna's Chairman and CEO Mark T. Bertolini said in a press release issued Monday night. "We will continue to evaluate our participation in individual public exchanges while gaining additional insight from the counties where we will maintain our presence, and may expand our footprint in the future should there be meaningful exchange-related policy improvements.”

Aetna said it will contact policyholders about their need to find new plans before this year's open-enrollment period starts.

The company did not offer plans in Lee, Collier or Charlotte counties. Though it did elsewhere in Southwest Florida, including Sarasota and Manatee counties.

County-level enrollment figures were not available. Amy Bogner, spokeswoman for Florida's Office of Insurance Regulation, said they are considered trade secrets.

Kevin Counihan, CEO of the marketplace exchanges, said government is working to improve risk pools. He also pointed to providers, such as Florida Blue, that are profiting from Affordable Care Act-compliant individual market policies.

“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," Counihan said in a written statement following Aetna's announcement. "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."

Gary Claxton, director of the Health Care Marketplace Project for the non-partisan Kaiser Family Foundation, said Aetna's decision is a blow to the 2010 health law. But a growing pool of beneficiaries should keep insurers in the exchanges, he said.

"It's kind of a sobering moment, but I do think there are other insurers doing better than some of the big, national ones," Claxton said. "What will be telling is how the next open enrollment goes and whether or not the market continues to grow or doesn't. If the market continues to grow there will be insurers that want to serve it."

Connect with this reporter: @FrankGluck (Twitter)