Aetna pulling out of Virginia ACA marketplace next year

Starting next year, Aetna clients in Virginia and other states will no longer be able to purchase individual or family health insurance plans through the Affordable Care Act marketplace.

The ACA is a 15-year-old federal law that allows people who don't have employer-provided insurance to purchase their own through the ACA marketplace. Congress also created associated tax credits that have helped some offset those costs even further. More than 261,000 people in Virginia have Aetna health care, according to the Virginia Department of Medical Assistance Services, and the soon-to-be extinguished plans cover nearly 5,000 enrollees as of January of this year.

Aetna is under the CVS umbrella and has participated in the ACA marketplace. Recipients have received emails this summer alerting them of the forthcoming change, and the company website outlines it as well.

"As we considered plan options for the future, it became clear we would not be able to provide the same level of value we've offered in prior years," the health insurer's website reads.

Both the online statement and a request for comment from CVS Health did not clarify what made it "clear" the company felt the need to withdraw, but the shifting federal health care policy landscape could be part of the equation.

Congress has yet to renew ACA tax credits that further help people lower their premium payments and the recently passed One Big Beautiful Bill Act did not extend the credits either.

Relatedly, the One Big Beautiful Bill Act includes forthcoming changes to hospital funding and Medicaid (another provision of ACA that helps insure pregnant people, children, those with disabilities and lower-income earners).

The Republican-led mega bill fielded opposition from Democratic and some GOP federal lawmakers but ultimately passed and was signed by President Donald Trump on July 4. Republican dominance in Congress also threatens the renewal of the ACA tax credits that help people purchase insurance in state marketplaces, which Democrats have championed.

An Aetna spokeswoman did not directly respond when asked if Congress' pending renewal or failure to renew ACA tax credits had anything to do with the decision. She did reiterate the same statement from the website that CVS remains "committed to helping members make the most of their benefits in 2025."

An email forwarded to the Virginia Mercury by a reader with Aetna insurance outlines how clients will need to shop for a new insurer when the 2026 enrollment period opens in the fall.

"You will get more information and helpful guidance as open enrollment approaches," the Aetna letter reads.

Aetna's recent communication to clients follows NPR reporting that Aetna would be withdrawing from the ACA marketplace back in May. Since then, as Congress debated the One Big Beautiful Bill Act, lawmakers and hospital professionals around the nation and in Virginia have expressed concerns about what shrinking health care coverage options might mean across all income brackets.

"As uninsured rates climb, so too will health care costs for everyone," said U.S. Rep. Jennifer McClellan, D-4th.

This story was originally published in the Virginia Mercury.