Aetna’s exit unsettles health marketplace

DOVER — And then there was one.

Aetna, the nation’s third-largest health insurer, told the Delaware Department of Insurance on Wednesday that it would not be participating in the Health Insurance Marketplace in 2018.

That leaves the state with one option — Highmark Blue Cross-Blue Shield of Delaware.

Aetna’s decision to exit the Health Insurance Marketplace affects 11,854 Delawareans who are insured through the insurance provider’s exchange plans. Coverage will last through the end of this year.

Aetna officials pointed to a $700 million loss for individual policies between 2014 and 2016 and estimated the company will lose an additional $200 million in 2017, which is its main reason for leaving the marketplace.

Aetna’s announcement certainly left many Delawareans scratching their heads and wondering what lies ahead, especially as Republicans are rewriting the Affordable Care Act, aka Obamacare, in Washington.

“(I) think the uncertainty regarding healthcare is a major factor in this,” said Dan Maher, who responded to a Delaware State News inquiry on the newspaper’s Facebook page. “If (Aetna is) leaving the Delaware Health Insurance Marketplace maybe they also need to forgo the portions of the state employees’ healthcare plans they are scheduled to assume on July 1, 2017.”

Dustin Knepper said that he will be among those left without insurance.

“(Blue Cross-Blue Shield) is too expensive,” he said. “I’m crossing (my) fingers President Trump comes up with a solution.”

Ramona Glover Lovett said she was scared and worried about the impact AETNA’s move will have on her family. “This affects me and my son. My son has asthma (and) needs meds regularly. He no longer qualifies for CHIP because my income falls a smidge over the income level requirements. I will lose insurance as well.”

The government-backed marketplaces are a pillar of the Obama-era federal law because they enable millions of people to buy health insurance with help from income-based tax credits. (Obamacare mandated that all Americans purchase health insurance or they will be forced to pay a fine.)

But insurers like Humana, and now Aetna, have been fleeing that market and the remaining coverage options are growing thin.

Tom Carper

U.S. Sen. Tom Carper (D) said that revamping the Affordable Care Act is something that must be done across party lines by both Republicans and Democrats in order to ensure that “quality, affordable” healthcare remains available to everyone.

“For years, we struggled to reform our health care system so that every family has access to affordable, high-quality health care,” said the 70-year-old Democrat. “By passing the ACA, we took a tremendous step toward making good on that promise. However, I’ve long said the ACA isn’t perfect, and that we should work together on a bipartisan basis to make it better.

“But I’m an optimist, and I’m not going to give up. I ask our president and my colleagues in Congress to see that they are not doing right by the people who sent them to Washington. I ask them to change course. If they’ll meet us halfway, they’ll find earnest partners in me and my fellow Democrats.”

About 12 million people bought coverage for this year on the exchanges, according to the Associated Press, and every market had at least one insurer offering coverage. However, a growing number were down to one.

According to the Associated Press, companies are in the middle of figuring out their prices and coverage plans for next year, and insurance experts expect some holes to develop in those marketplaces.

Chris Coons

In an interview with Fox News, U.S. Sen. Chris Coons, a Democrat, said the current Affordable Care Act is unstable due to uncertainty about what direction the Trump Administration is going to take on the issue.

“Unfortunately, we’re in a game of ‘chicken’ right now,” said Sen. Coons, 53. “We can debate whether or not there’s a ‘death spiral’ or whether the Affordable Care Act is stable, but the reality in the meantime is lots of my constituents in Delaware are calling me and saying ‘what am I supposed to be doing for health care this year?’

“We should work together and find a constructive answer that moves us all forward.”

Delaware Insurance Commissioner Trinidad Navarro said he can understand Aetna’s dilemma.

“I am disappointed that Aetna will not be servicing the health needs of Delawareans in 2018,” he said. “Given the uncertainty and instability surrounding the future of the Affordable Care Act, however, I understand their reasoning.

“I would hope that our elected officials in Washington will come up with solutions to guarantee that health insurance in Delaware and elsewhere is both available and affordable. Continuing funding for cost-sharing reductions is a first step in the right direction.”

The Associated Press says that ultimately, insurers with the most common brand in health insurance, Blue Cross-Blue Shield, will decide the fate of the marketplaces.

Many of those plans specialize in individual insurance and have a long-standing presence in their markets. They also are the only remaining option on exchanges in nearly a third of the nation’s more than 3,100 counties.

Consumers who have questions regarding Aetna’s departure are encouraged to contact the Delaware Department of Insurance at 1-800-282-8611 or 302-674-7300, or by e-mail at DOI_Consumer_Resource@state.de.us.

Delaware State News staff writer Mike Finney can be reached at mfinney@newszap.com.

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