Aetna, Inc. informed the Delaware Department of Insurance that it would not be participating in the Health Insurance Marketplace (“Marketplace”) in Delaware for 2018.
The carrier cited an approximate $700 million loss for individual policies between 2014 and 2016, and an estimated loss of $200 million for 2017 throughout the United States.
Highmark Blue Cross and Blue Shield, the other marketplace carrier has not announced its intentions for 2018. Highmark has also reported losses.
The marketplace is a small part of the total health care market, but has struggled under the Affordable Care Act, also known as Obamacare. In a few states, all carriers have announced plans to exit the market in 2018.
Customers for the marketplace are often business owners, consultants or early retirees who do not have access to group coverage.
In response, Insurance Commissioner Trinidad Navarro issued the following statement:
“I am disappointed that Aetna will not be servicing the health needs of Delawareans in 2018. 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.”
There are currently 11,854 Delawareans insured through Aetna’s exchange plans. Coverage will last through the end of 2017. After that period, anyone with a pre-existing condition for which they were begin treated may be able to continue having that treatment covered with that provider.
Carriers have been pulling out of states, due to losses and uncertainties with health care coverage.
Carriers unestimated the costs of insurance as sicker people without coverage moved into the system and began receiving treatment.
House Republicans passed a replacement to the Affordable Health Care Act. by a narrow margin. However, it remains unclear as to whether the bill would aid the marketplace. The bill now goes to the Senate
Consumers who have questions regarding Aetna’s departure are asked 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.
