Thursday, August 18, 2016

Aetna's Exit From Obamacare Constricts Insurance Choices

Aetna's decision to partially withdraw from a major provision of President Barack Obama's health care law is leaving some Americans with only one or no health insurance options, threatening the law's promise to continue to reduce the number of people who have historically been too sick or too poor to access coverage.

Aetna, retaliating in part against a Department of Justice lawsuit, announced Monday that it was leaving exchanges in 11 states, following a string of similar announcements earlier this year that came from other large insurers like UnitedHealth and Humana.

The exchanges, or marketplaces, allow some Americans who don't get health insurancefrom an employer to compare different plans and buy them at a tax-subsidized rate, mostly in the form of reductions to the amount they pay for their policies each month.

But with insurers choosing not to participate, in part because they are losing money by covering people who are sicker and seeking out immediate care after having insurance for the first time, people who shop for these plans are left with even fewer options to choose from. Some will have only one plan to select, and at least one – Pinal County, Arizona – will have none.

The Obama administration's response is to point out that health insurance companies are still adapting to the law and that millions of people will continue to receive coverage. Officials also point out that health insurance companies can leave or join the marketplace each year. But for many customers, Aetna's pullout will be more than just an inconvenience.

[READ: Trouble for Obamacare: Aetna Reduces Exchange Presence]

Roughly 670,000 people who had Aetna in June will lose their plans and will need to choose new ones, or they can go uninsured or pay more for policies by buying plans outside the exchanges. But their new plans might not cover the doctors they've been seeing for years or the hospital they would prefer. If they are in the middle of treatment at a particular facility, they might also have to transfer all their medical records.

"It's not like switching from Crest to Colgate," says Charles Gaba, an independent analyst and author of the blog "It’s not even like switching from Sprint to Verizon, which is more headache-inducing.”

Exchange customers in rural Knox County, Missouri, are likely to have only one health insurance company to choose from, given that they're losing Aetna and UnitedHealth Care.

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