News & Commentary

Iowa Blue, Aetna Exit ACA Exchange


Frank Diamond

Thousands of Iowans will have to scramble for health coverage after last month’s announcement by two major insurers that they will no longer be participating in the state’s ACA exchange. Wellmark Blue Cross and Blue Shield and Aetna both say that they were not making enough money on the exchange because those enrolling tend to be a sicker population that’s costly to care for. The lack of participation by young invincibles is a structural problem long noted by both opponents and proponents of Obamacare.

Officials with both health plans also noted Washington’s inability to clearly define for insurers what awaits them. Republican plans to repeal and replace Obamacare were shelved in March for lack of enough GOP support in the House.

Aetna and Wellmark’s moves amount to a one-two punch for Obamacare in Iowa. Reuters: “According to data provided by Iowa, Aetna accounted for most of the plans sold on the federally run Healthcare.gov website in 2016. Wellmark accounted for most of the plans sold in the state that comply with Obamacare but are not sold on Healthcare.gov.” Aetna has about 30,000 covered lives under Obamacare; Wellmark about 21,000.

Aetna hasn’t made any decisions about remaining on the exchanges in Delaware, Nebraska, and Virginia. And Aetna isn’t the only health insurance plan showing hesitation.

Reuters reported that many health plans “worry that Republicans have not said they will extend billions of dollars of subsidies into 2018 and that lawmakers might make other major changes, such as scrapping the requirement that all Americans must have health coverage or pay a fine.”

Wellmark’s CEO John Forsyth told the New York Times that “while there are many potential solutions, the timing and relative impact of those solutions is currently unclear. This makes it difficult to establish plans for 2018.”

Wellmark covers about 1.7 million people in the state, most of them through employer-sponsored health plans.

Doug Ommen, Iowa’s insurance commissioner, pointed out that his is not the only state faced with this reality. “It’s concerning given that Iowa has now had two carriers leave the ACA’s individual health insurance market,” he said. “We will continue looking for ways to protect Iowa consumers.”

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