Aetna CEO: ‘Too early to give up’ on ObamaCare marketplace

The CEO of Aetna, one of the country’s largest health insurers, says the company is not giving up on the ObamaCare marketplaces despite losing money in them in 2015. 

{mosads}”We believe it’s incredibly important in the business we’re in that we insure all Americans,” CEO Mark Bertolini said at the JP Morgan Healthcare Conference in San Francisco. “This is our first attempt to make this happen, and we believe we have an obligation to stick it out and work with it until we know that it won’t work, and I believe it is too early to give up on this process.”

Insurers selling insurance on the ObamaCare marketplaces were widely seen as having set prices too low at the outset and having gotten sicker and more costly customers than they expected. Insurers corrected for that by raising premiums somewhat for 2016. 

The comments contrast with those of another big insurer, UnitedHealthcare, which made waves in November by saying that it might pull out of the marketplaces by 2017 because of losses. That announcement was followed by some commitments to the marketplaces by other insurers. 

Bertolini said Aetna had losses in the marketplaces of “mid-single digits” in 2015 and had priced to reverse that and get “mid-single digit” growth in 2016. 

Furthermore, he noted that the ObamaCare marketplaces are not make-or-break for the company, saying they represent 5 percent of membership and 6 percent of revenue. 

“So from a tactical standpoint, this is not breaking the bank one way or the other,” he said. 

The Obama administration also says that it is seeking to make the market more stable for insurers. 

Andy Slavitt, the acting head of the Centers for Medicare and Medicaid Services (CMS), spoke at the same conference and said he would tighten up ObamaCare’s “special enrollment periods.”

Those periods are times outside of the normal sign-up window when people can enroll in coverage if they fit certain circumstances, such as losing other coverage or getting married. 

However, insurers complain that people are gaming the system and using these periods to sign up only when they get sick, leading to heavier losses for insurance companies. 

“There are some [special enrollment periods] that we need to clarify because they’re subject frankly to abuse,” Slavitt said.