As Republicans ready a new bid to repeal and replace Obamacare, two companies announced moves that could serve as significant blows to some of the law's individual health insurance exchanges.
Aetna on Wednesday announced that it plans to exit the Virginia individual insurance market both for Affordable Care Act exchanges and off-exchange plans.
That will leave Aetna with just two states in which it is offering plans through the ACA exchanges.
"Despite significantly reducing our exchange footprint, our individual Commercial products could potentially lose more than $200 million in 2017," the company said in a statement. "Based on that financial risk, and growing uncertainty in the marketplace, we will not offer on- or off-exchange individual plans in Virginia for 2018."
Meanwhile, Medica — a smaller Minnesota-based insurer — said it is heavily considering abandoning the ACA exchanges in Iowa, which would leave all but five counties in the state without an insurer in the marketplace. Aetna and Wellmark, a Blue Cross Blue Shield system company, left Iowa's exchanges in April.
Medica cited political uncertainty as a major factor for its considerations to leave Iowa's exchanges.
"Without swift action by the state or Congress to provide stability to Iowa’s individual insurance market, Medica will not be able to serve the citizens of Iowa in the manner and breadth that we do today," Medica said in a statement. "We are examining the potential of limited offerings, but our ability to stay in the Iowa insurance market in any capacity is in question at this point."
In addition to the battle over the American Health Care Act, the GOP's bill to overhaul the US healthcare system, the Trump administration has not committed to funding cost-sharing reduction (CSR) payments beyond May. Those payments help offset the cost of providing low-cost plans on the exchanges to poorer Americans. Without CSR payments, many insurers said they would be forced to leave the exchanges.
Aetna's situation is a bit more complicated, with the termination of a planned merger with rival Humana and shifts in its business likely contributing to its decision in Virginia along with political uncertainty.
The company did not give a firm commitment to stay in its last two Obamacare markets — Delaware and Nebraska.
"We will communicate decisions on our remaining states as appropriate," Aetna said.
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