Health and Science

Aetna will exit Obamacare markets in Virginia in 2018, citing expected losses on individual plans this year

Key Points
  • Aetna had sold Obamacare plans in 15 states in 2016
  • The insurer said it would not sell Obamacare plans in Iowa next year.
  • Aetna expects it could lose $200 million or more this year on Obamacare plans.
Aetna won't offer individual Obamacare plans in Virginia
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Aetna won't offer individual Obamacare plans in Virginia

Giant insurer Aetna on Wednesday continued an ongoing retreat from the Obamacare business, announcing it will not sell such health plans in Virginia next year because of expected financial losses.

Aetna left open the question of whether it will sell individual health plans anywhere next year.

The insurer, which last month announced it would exit Iowa's Obamacare market in 2018, sells individual plans in just two other states this year: Delaware and Nebraska.

"Despite significantly reducing our exchange footprint, our individual commercial products could potentially lose more than $200 million in 2017," said Aetna spokesman T.J. Crawford in an email.

"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."

"We will communicate decisions on our remaining states as appropriate," Crawford said.

The email contains a graphic image depicting Aetna's approximate pre-tax losses on Obamacare plans since they began being sold in 2014. They go from about $100 million that year, up to $130 million in 2015, and about $450 million last year.

The pull-out of Virginia, Iowa, and potentially the other two states will not affect customers covered by Aetna through either their employer, or through Medicaid and Medicare Advantage plans.

The move only relates to individual plans sold on and off of the federal Obamacare exchange HealthCare.gov.

Aetna sells health plans in 50 of Virginia's 95 counties, according to data from the Robert Wood Johnson Foundation. In 24 counties where it operates, there is just one other insurer selling Obamacare plans: Anthem, under the brand name HealthKeepers.

Anthem has already filed paperwork related to potentially selling plans in 2018 in Virginia.

However, Anthem and other insurers have warned that if they are not guaranteed federal subsidies for reducing out-of-pocket health costs for low-income customers, they may have to either raise rates for 2018 plans, or not sell them altogether.

A spokesman for Virginia's insurance commissioner declined to comment when asked about Aetna's decision.

Aetna last year sold individual Obamacare plans in 15 states. But it retreated to just four states in 2017 because of losses from the plans.

Aetna CEO Mark Bertolini on Tuesday had told CNBC's "Closing Bell," that given the expected losses for 2017, "we're evaluating the markets as we speak."

"We will be notifying some other states shortly. We only have four states remaining, so our presence will be smaller than it is this year," Bertolini said that day.

Aetna on Tuesday reported earnings for its overall business that were better than had been expected by analysts.

The insurer reported a net loss of $381 million, or $1.11 per share, in the first quarter of 2017, ending March 31. The company had a profit of $737 million, or $2.08 per share, in the same quarter a year earlier.

Aetna said the quarter's loss was due mainly to costs linked to the end of a merger agreement with Humana.