Aetna to leave Iowa health insurance exchange

April 06--Three days after Wellmark Blue Cross and Blue Shield announced it would stop selling individual health plans on or off Iowa's Affordable Care Act exchange in 2018, health insurer Aetna has reached the same conclusion, citing "financial risk and an uncertain outlook."

Thursday's development leaves the vast majority of the 50,000 Iowans purchasing subsidy-eligible insurance on the exchange with only one option -- Minnesota-based Medica.

"Aetna did notify the office this morning and advised us they won't offer coverage for 2018," Iowa Insurance Commissioner Doug Ommen said. "We're deeply troubled by the angst and concern the Affordable Care Act is causing in Iowa. This is a problem created by the Affordable Care Act and needs to be fixed by Congress."

The problem Wellmark, Aetna and other insurers are facing is that not enough young and healthy people are choosing to enroll in plans to help spread out costs. Instead, older, sicker individuals with multiple chronic illnesses -- who need insurance and coverage -- are purchasing the health plans, putting a high concentration of expenses in the individual market.

Wellmark said on Monday that it lost $90 million through the individual market in Iowa.

An Aetna spokesman said the company still is evaluating its presence in remaining states, which includes Delaware, Nebraska and Virginia. The insurer announced in August it would pull out of most states.

The Iowa Insurance Division said Aetna reported 32,822 Iowans on the marketplace and 3,383 Iowans off the marketplace will be affected.

Medica, the only remaining insurer selling ACA exchange plans statewide, said earlier this week it has not made a decision regarding its 2018 strategy -- a comment it reiterated after Thursday's announcement.

"We are currently evaluating the situation and our options," said Greg Bury, a Medica spokesman.

The company currently has 14,000 Iowa members. Medica has until mid-June to decide if it will sell plans in 2018.

One other insurer, Gundersen Health Plan, sells individual policies but only in five Iowa counties.

President Donald Trump and Republicans have promised to repeal and replace the 2010 Affordable Care Act, often called Obamacare, but have been stalled by disagreement over the changes they will make.

Insurers have said uncertainty over which rules will be in place in 2018 and the billions of dollars in government subsidies that make the plans more affordable to millions of people make it difficult to commit to offering such insurance.

Many have asked the government to extend the subsidies for 2018.

Health insurers are preparing 2018 premium rate proposals to submit to federal and state insurance regulators over the next few months.

The federal Centers for Medicare and Medicaid Services, which regulates the Obamacare individual market, was not immediately available for comment, Reuters said.

Reuters contributed to this story.

l Comments: (319) 398-8331; chelsea.keenan@thegazette.com

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