- Aetna CEO Mark Bertolini has responded to a letter from a group of senators who accused the company last week of exiting the majority of its ACA markets as a ploy against the federal government for challenging Aetna's proposed merger with Humana.
- Bertolini dismissed the senators' arguments as "unfounded accusations," the Hartford Courant reported.
- Aetna spokesman T.J. Crawford told the Courant the company had not received a response from the senators.
Bertolini said the letter, from Senators Elizabeth Warren (D-MA), Bernie Sanders (I-VT), Edward J. Markey (D-MA), Sherrod Brown (D-OH), and Bill Nelson (D-FL), made numerous "unfounded accusations" about Aetna's intentions. The group had not only suggested that Aetna threatened to leave the exchanges if its merger was not approved, but that it had structured its merger from the start to be too risky to deny -- to Aetna and thereby the exchanges -- by including a clause for $1 billion in payment to Humana if the deal is not sealed on time.
The CEO took the opportunity to remind the senators why other insurers including UnitedHealth are also dumping significant portions of their ACA business and suggested to call out Aetna in particular is in itself a political maneuver that distracts from the problems under the ACA.
"In this highly politicized environment, it may be tempting to make such accusations rather than examine the forces creating an unsustainable public exchange marketplace," he said, "but they do not move us toward fixing the problem."
Another factor Bertolini added was that the company currently expects to lose $650 million on its 2016 exchange business, up from its earlier estimate $525 million. It lost $475 million in 2015.
He pointed toward an "unsustainable imbalance" in the ACA markets' risk pool due to policies that result in a disproportionate number of sick enrollees vs. healthy. "The occurrence of those negative developments was the actual catalyst for our decision to reduce our footprint," he stated.