Aetna CEO: ACA return possible, but not until 2019

Aetna could return to some of the Affordable Care Act (ACA) exchanges it left for 2017, but not until changes are made to the market by Congress and federal regulators.

Aetna CEO Mark Bertolini told Bloomberg it would consider boosting its ACA offerings if reforms help insurers cover a sicker-than-expected risk pool. The company lost hundreds of millions on ACA plans, leading to it reducing its participation on the exchanges to four states in 2017 from 15 in 2016.

The market’s stability is threatened, Bertolini said, by the risk pool pushing premiums up, which begins the cycle of continually increasing costs driving more and more healthier customers away.

“As the rates rise, the healthier people pull out because the out-of-pocket costs aren’t worth it,” Bertolini said at Bloomberg’s The Year Ahead Summit in New York. “Young people can do the math. Gas for the car, beer on Fridays and Saturdays, health insurance.”

For more on the changes Bertolini wants to see before Aetna restarts sales on the exchanges, click on the link below: 

""
John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

Around the web

Compensation for heart specialists continues to climb. What does this say about cardiology as a whole? Could private equity's rising influence bring about change? We spoke to MedAxiom CEO Jerry Blackwell, MD, MBA, a veteran cardiologist himself, to learn more.

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”