[ad_1]
By TOM MURPHY, The Associated Press
Aetna will abandon the Affordable Care Act insurance exchanges next year in more than two-thirds of the counties where it now sells coverage, the latest in a series of defections by large insurers that will limit customer choice in many markets.
The declining participation of insurers is becoming a concern, especially for rural markets, in part because competition is supposed to help control rising insurance prices, and many insurers have already announced their intention to seek solutions. increases of about 10% or more for 2017.
“It’s really going to be felt in southern states and rural areas,” said Cynthia Cox, associate director of health reform and private insurance for the Kaiser Family Foundation, which studies health issues.
Aetna is not an insurer under the Affordable Care Act in Colorado, said Karen Henderson, spokesperson for Connect for Health Colorado.
Experts say it’s too early to determine how declining insurer participation will affect rates beyond next year, but fewer choices typically contribute to higher prices over time.
Aetna, the country’s third-largest insurer, has announced that it will limit its participation in stock exchanges to four states in 2017, up from 15 this year. The announcement on Monday night came weeks after UnitedHealth and Humana also announced that they would cut their coverage plans for 2017 and after the closure of more than a dozen nonprofit insurance co-ops over the two last years.
The Kaiser Family Foundation estimated earlier this year that about one in five U.S. counties could be reduced to a single health insurer on its public stock exchanges by next year, and about 70 percent of those markets will be rural. This was before Aetna announced her changes. Cox said the total could be closer to one in four now.
Rural markets may be less attractive to insurers because there are fewer clients to spread costs over, and hospitals and other health care providers may acquire dominant positions in the market, making them better able to negotiate the rates. In contrast, urban markets, where most people live, should still have plenty of health insurance choices on their trades for 2017.
Alabama, Alaska and Oklahoma are among the states that will have a health insurer selling individual coverage on their exchanges next year. South Carolina and most of North Carolina could join this list due to the Aetna decision, Cox noted.
Aetna’s withdrawal leaves Pinal County outside of Phoenix with no insurer selling individual coverage for next year on the exchange, although some are selling off-exchange coverage, according to the Department of Arizona Insurance.
The exchanges have helped millions of people gain medical coverage, most through income-based tax credits. But insurers say this relatively small slice of business has generated huge losses since they started paying claims in 2014. Insurers have struggled to enroll enough healthy people to balance claims that ‘They pay to customers at high cost, and they have complained about a significant lack of support from government programs designed to help them.
The country’s largest insurer, UnitedHealth Group, sold coverage in 34 states this year. But it only plans to offer policies in three states next year: Nevada, Virginia and New York.
Aetna covers around 838,000 people on the scholarships and said it was overwhelmed with higher-than-expected costs, especially from expensive specialty drugs. It will sell coverage on stock exchanges in 242 counties next year, up from 778. The Hartford, Connecticut-based insurer will sell on the Delaware, Iowa, Nebraska and Virginia stock exchanges the year next.
As insurers like Aetna and UnitedHealth reduce their participation in exchanges, competitors like Cigna and Molina Healthcare are growing.
Sabrina Corlette, a research professor at the Georgetown Health Policy Institute, said it could take a few more years for participation in the exchange to take hold and the government may need to change some of the market rules. “But I don’t think the markets are crashing and burning by any means,” she said.
Government officials say trade is improving and healthier people are signing up, helping insurers balance the claims they receive from sicker customers.
“Aetna’s decision to change its market participation does not change the fundamental fact that the health insurance market will continue to provide quality coverage to millions of Americans next year and every year thereafter. “said Kevin Counihan, CEO of federal exchange operator HealthCare. gov, in an emailed statement.
Even Aetna did not give up on this case. President and CEO Mark Bertolini said in a statement that the insurer may expand its trading business in the future “if there are significant improvements in trade-related policies.”
Membership period for 2017 coverage begins November 1.
[ad_2]
