- Aetna said Thursday that it will exit Iowa’s individual public ACA exchange in 2018, due to financial risk and uncertainty about the ACA’s future, Forbes reported.
- The news is a double whammy for Iowans who get healthcare coverage under the Affordable Care Act, coming just days after Wellmark Blue Cross Blue Shield announced it will not sell plans in Iowa next year.
- That leaves 94 counties, including Des Moines, with one insurer, Medica. Five other Iowa counties down to two payers — Medica and Gunderson Health Plan, according to the Washington Examiner.
The uncertainty surrounding how the government will or won't help the ACA individual insurance market has increased unease among payers about their financial vulnerability in an unstable marketplace. Lawmakers are now heading out for a two-week Easter recess with no clear plan going forward for an ACA fix or repeal and replace.
Last year, Aetna announced it was pulling out of 11 state ACA exchanges. The company currently offers on-exchange health plans in just Delaware, Iowa, Nebraska and Virginia.
Wellmark cited losses of about $90 million on ACA exchanges over the past three years in its decision to leave Iowa. But officials also hinted a lack of direction from Capitol Hill played a role.
Other insurers that have pulled back from the marketplace include Humana, which is exiting all ACA exchanges after this year, and Blue Cross and Blue Shield plans.
Insurers have blamed their difficulties on too few young and healthy patients signing up for ACA plans. To curb their losses, they have resorted to higher premiums and fewer options.
There is also concern about the ACA’s viability if Congress does away with the federal cost-sharing subsidies for low-income enrollees. According to a new Kaiser Family Foundation analysis, plans insurers would need to raise the premium for a benchmark silver plan about 19% to make up for lost funding if they don’t receive the subsidies.
Of the 12.2 million people who got coverage in 2017 through an ACA exchange, about 58% received cost-sharing reductions, the foundation says.