Delaware Public Media

Aetna pullout could mean higher costs, less options in marketplace

May 11, 2017

Aetna’s decision on Wednesday to pull out of Delaware’s Affordable Care Act marketplace will most likely mean higher rates and less options for people who rely on the exchange for health insurance.


Nearly 12,000 people in Delaware will lose their Aetna exchange plans at the end of the year.

Delaware Insurance Commissioner Trinidad Navarro is hoping the state’s sole remaining provider, Highmark, will insure them.

"Keep in mind, we have not seen what Highmark is going to ask for in respect to a rate increase. And I have seen across the country rate increases in excess of 50 percent in other states,” he said.

Odds are Highmark won't hike it's rates 50 percent. And there's a chance rates could stay the same. But without competition, Highmark has more leeway to try to recoup losses by raising rates.   

That means Delawareans could be paying more for less options next year.  

Aetna cited multimillion dollar losses over the past few years for its decision to pull out. 

Highmark has also been posting multi-million dollar losses in recent years, including a loss of $500 million in 2015.   

Navarro said that’s because the Republican controlled Congress hasn’t been reimbursing insurers for selling plans in the high risk exchanges.  

With insurers bleeding money, it's possible Highmark could also pull out of Delaware's marketplace next year.

 

That would leave the more than 27,000 people in Delaware who rely on the state exchange for health insurance with no options.

 

But Highmark has indicated it will return to the exchange next year (although Aetna indicated it would too back in February). And it's likely it will take advantage of the lack of competition and charge as much as it can to stay viable.   

 

But even with one insurer, the state exchange will continue to face an uncertain future until lawmakers fix or replace Obamacare.

Navarro said the ACA may be the law of the land, but without support from Congress or the president it’s destined to fail.

 

“It’s losing its teeth. It’s losing its bloodline. I think the president’s going to get exactly what he wants, the demise of the Affordable Care Act,” he said.