Published: Fri, May 12, 2017
Local | By Dorothy Bennett

ACA exchanges grow thinner with Aetna leaving for 2018

ACA exchanges grow thinner with Aetna leaving for 2018

Aetna said Wednesday it will be completely exiting the Affordable Care Act (ACA) exchange markets next year by not participating in DE or Nebraska exchanges. For example, BlueCross BlueShield of Tennessee recently said it would serve those abandoned 16 Tennessee counties, but health policy experts do not expect it to happen very often because it is so expensive to launch coverage into new markets, especially at a time when the federal rules are in flux.

Earlier, Aetna AET, +0.45% announced it was leaving the exchanges in Iowa and Virginia, its other two current marketplace states.

The decision will leave the state of Nebraska with just one remaining insurer.

Iowa is the only state at possible risk of having no exchange plans offered in 2018, Perlman said. And while this may have eventually played into Aetna's decision, the reality is the exchanges simply have not been profitable. He said recently that with a Republican Congress deadlocked over efforts to repeal the law, Congress should instead turn to a long-overdue fix.

"It's hard to say whether Aetna would have stayed in the market under different circumstances, but we are seeing a number of insurers expressing concern over the political and regulatory uncertainty they face next year", said Cynthia Cox, associate director at the Kaiser Family Foundation. The ACA prevents insurers from rejecting patients based on their health.

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Evercore ISI said DE exchange sign-ups fell 2.4 percent year-over-year in 2017, while sign-ups in Nebraska fell 3.9 percent, which was close to the 3.7 percent nationwide drop. The report adds that "Aetna's exit leaves Medica as the only insurer on the Nebraska exchange and Highmark Blue Cross Blue Shield as the sole carrier on the DE exchange". They also are the only remaining option on exchanges in almost a third of the nation's more than 3,100 counties.

Anthem, Centene, Molina and BCBS plans have "for the most part said they are in wait-and-see mode", he said.

The White House has assured lawmakers it will continue making payments, but it has offered no long-term guarantee.

Customers won't know for several more months for sure what their options are for next year.

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