- Aetna, the insurance arm of CVS Health, will begin selling Affordable Care Act plans in California, Delaware, Illinois and New Jersey next year, bringing its total ACA presence to 12 states, the payer announced Thursday.
- Aetna is entering the four states’ individual exchange marketplaces with its Aetna-CVS Health co-branded plans, which combine Aetna’s provider network with other CVS services like telehealth and walk-in clinics, including MinuteClinic and HealthHUBs.
- CVS is also expanding into new counties in Arizona, Florida, Missouri and Texas for next year. The payer is remaining, but not expanding, in Georgia, North Carolina, Nevada and Virginia.
CVS is the latest payer to announce an expansion of its ACA offerings as enrollment in the exchanges swells, spurred by financial incentives solidified by Democrats earlier this year, COVID-19 special enrollment periods and economic uncertainty destabilizing job-based coverage.
A record 14.5 million Americans signed up for ACA plans for 2022, the highest volume since it was signed into law 12 years ago.
On an earnings call with investors in early August, CVS CEO Karen Lynch said the payer planned to enter the exchanges in four new states in 2023. The insurer has been bullish on expanding its ACA footprint since 2021, when its payer business Aetna said it would return to the exchanges after exiting them in 2017.
Late last month, Connecticut-based Cigna announced it would be entering three new states in 2023.
And a number of payers including CVS, Cigna and UnitedHealthcare expanded their ACA footprints for coverage for 2022.
CVS did not disclose how many new customers Aetna expects to reach in the expansion. But the counties the payer is targeting are among the most populous — for example, in Illinois, the offering will be available in Cook County, which includes more than 40% of all Illinois residents; and in New Jersey, the offering will be available in 18 counties, including Bergen, Middlesex, Essex and Hudson — some of the largest in the state.
CVS has increasingly looked to tie its insurance benefits into its national footprint of brick-and-mortar pharmacies, clinics and stores to get a greater slice of revenue. The company is also bullish on building out its primary and home care offerings, potentially resulting in downstream savings for Aetna.
Earlier this month, CVS agreed to acquire Dallas-based home care company Signify Health for $8 billion, winning out over other interested bidders including Amazon and UnitedHealth. The acquisition, if finalized, should speed CVS’ transition to a full-service healthcare provider by bringing some 10,000 doctors in-house, along with technology to help coordinate at-home medical services.