Aetna will drop out of health insurance exchanges if they are not profitable enough

[eridani]

http://investor.aetna.com/phoenix.zhtml?p=irol-eventDetails&c=110617&eventID=48891183
Q1 2013 Earnings Conference Call
Mark Bertolini - Chairman, CEO and President, and Shawn Guertin - Chief Financial Officer

Guertin: On the individual and small group, it is not a function of irrational pricing in any way, shape or form. We've talked before about the importance of having solid operating margins going into 2014, and so we have continued to err on the side of caution in our pricing on that product. And as I mentioned we'll favor sort of margin over membership on this.

Bertolini: We are entering these exchanges very carefully. We are about two-thirds of the way contracted for our exchanges. Those tend to be narrow networks that are generally 25 to 50 percent of the size of our base networks in those marketplaces. Currently the rates we're getting for most of those networks is between Medicare and commercial, based on the narrower networks, the closer we get to Medicare. The rates will really be based on geography and probably, more importantly, will be based on how much we get the network contracted. So our approach in the initial pricing that we've submitted to the exchanges has been focused on where we have rates on a document inked. We've included those into our cost structure. Where we do not, and we need to add providers for network sufficiency, we're pricing those at commercial pricing until we otherwise know that we have a betterrate. And, as you know, the negotiations will take place through the summer and into the fall. Obviously, at the end of all of this, we have an opportunity to pull out in September, and we continue to hold that as an option should the exchanges not develop favorably, or they ask for unreasonable rates by the time we need to close on participation.

Comment by Don McCanne of PNHP: In this quarterly earnings conference call, Aetna's Mark Bertolini and Shawn Guertin demonstrate their executive skills in guiding this large insurance corporation in the direction of providing the greatest returns for the investors. From a corporate governance perspective, that's exactly as it should be. How well does that work from the perspective of our health care system?

Chief Financial Officer Guertin says that they will favor "margin over membership." That is, they will sacrifice the option of bringing more people under the insurance umbrella in exchange for greater profits for the Aetna investors. Is limiting access to the payer of health benefits a policy decision that we want driving our health care system?

Chairman Bertolini says that they intend to reduce the size of their already-limited provider networks by one-half to three-fourths in order to use that leverage to squeeze payment rates for their remaining providers. So they are deliberately removing choices that patients would have in selecting their health care professionals and institutions for the purpose of increasing their margins (profits). Is impairing access by restricting choice a policy decision that we want made for our health care?

Chairman Bertolini also says that they will continue to hold onto the option of pulling out of the exchanges if they do not "develop favorably" or if "they ask for unreasonable rates." Is this a policy to take care of patients, or one to take care of investors?

Imagine a public single payer program, such as an improved Medicare that covered everyone. "Margin over membership" would be unheard of. As a universal system, everyone would be included. It would be inconceivable that the stewards of the system would limit the numbers enrolled as a means of generating more favorable balance sheets.

It's the model that's wrong. We need to change it.

[Warpy]

1. They all will, and then some of them will likely drop out of

whole states that aren't profitable enough.

At that point, single payer is likely to gain some traction, at least on a state by state basis.

Too bad that fucker Lieberman was re elected. He single handedly stopped the lowering of the Medicare eligibility age to the more reasonable 55.

[ProSense]

15. Aetna is

"They all will, and then some of them will likely drop out of whole states that aren't profitable enough. At that point, single payer is likely to gain some traction, at least on a state by state basis. "

...basically full of shit. This is a mind game. Insurance companies can be kicked out of the exchange if they don't follow the rules. Not being on the exchange is going to be horrible for any insurance company. Companies and people will simply switch to another insurance company on the exchange.

IOW, Aetna's rhetoric is the quickest path to irrelevance. Let them drop out.

[zipplewrath]

18. Well, they can leave too

All the guy really said is that they won't take the risk on exchanges where they don't have pricing in place (i.e contracts with providers). If they don't have pricing, they'll use commercial rates (i.e. "full price&quot . And finally he basically said that they won't participate where the profit margins are too small. None of that is particularly earth shaking. The places where this may be most significant is in small markets where there isn't much business worth chasing. In the larger markets, they probably already have a presence.

[ProSense]

19. Well,

"And finally he basically said that they won't participate where the profit margins are too small."

...let them, and since it's OK to put profits ahead of people's health and lives, what's "too small"?

These insurance companies are greedy bloodsuckers.

[zipplewrath]

20. But it's not an empty threat

You suggested that their statements were "BS". I don't think they are kidding when it comes to small markets, especially where they don't have an existing presence. If the margins get too small, they'll leave it to competitors to fill in. (I'd guess around 7-13% margin) Now, in large markets, they may be afraid to not join in and figure it out as the go along, but I'd suspect they are already in those markets and know the costs well.

You can say "let them" but those small markets may have trouble getting companies to populate their exchanges. It was one of the reasons that the left rejected the whole "just let companies sell across state lines" schtick the GOP was selling. There are small markets in which there may only be 1 or 2 significant sources. It isn't clear that other companies would move into those markets, with our without national insurance reforms.

[ProSense]

23. No,

"But it's not an empty threat...You suggested that their statements were 'BS'. I don't think they are kidding when it comes to small markets, especially where they don't have an existing presence."

...it's BS like all the other anti-Obamacare rhetoric: http://www.democraticunderground.com/10022580511

Threatening to leave the exchange is beyond BS. They're trying to give the impression that somehow that will be a more "profitable" move.

[ProSense]

24. Also, if it's

"not an empty threat," maybe Aetna should start packing. They may not see the "profits" they're expecting.

Study: Obamacare May Reduce Premiums In New York
http://www.democraticunderground.com/10022804988

I don't think anyone will miss them.

[zipplewrath]

28. Large markets

I wouldn't expect them to leave a large market like New York. That would be expected in smalller markets, mostly where they don't have any current presence. It wouldn't be a case of "packing", but not arriving in the first place.

[ProSense]

29. First,

"I wouldn't expect them to leave a large market like New York. That would be expected in smalller markets, mostly where they don't have any current presence."

...you're arguing like this is a justifiable argument: insurance companies putting profits first.

"It wouldn't be a case of 'packing', but not arriving in the first place."

Clearly, there needs to be some reconciliation between your comment and the OP title:

"Aetna will drop out of health insurance exchanges if they are not profitable enough"

[zipplewrath]

34. Sure, no problem

Aetna stated that they would move forward based upon commercial pricing in areas where they did not have their own pricing data (I presume they meant where they already had contracts and negotiated prices). If the profit margins in those exchanges got too low, they would then "drop out" of those markets. i.e withdraw from the process of applying/offering (I think they stated September as their time frame to be able to do that). They were pretty clear that their areas of concern was where they didn't have pricing data. And they used the expression "margins" meaning that it isn't just enough to make money, but that they have certain margins that they target. I'd guess it is somewhere near what they can achieve by merely investing their money in the market, as oppose to the risk of exchanges in which they don't have data.

As for justifying insurance companies putting profits first, that is the system Obama set up. He even placed a 15% maximum on it (20% if you're small enough). Hey, most of us were suggesting the public option, or single payer. But he chose to mandate that individuals purchase insurance from private providers. I'da gone the whole public route.

[ProSense]

35. So

"If the profit margins in those exchanges got too low, they would then "drop out" of those markets. i.e withdraw from the process of applying/offering (I think they stated September as their time frame to be able to do that)."

...saying it's about Aetna "not arriving in the first place" is inaccurate. The company arrived, and then decided profits were more important.

"As for justifying insurance companies putting profits first, that is the system Obama set up."

So it's Obama's fault that Aetna is displaying its greedy predator side by threatening to drop out of the exchanges?

Maybe the President deserves thanks for exposing them and for putting them in a position that will rid us of them.

[zipplewrath]

36. Yes

So it's Obama's fault that Aetna is displaying its greedy predator side by threatening to drop out of the exchanges?

Yes, his and the senators that set up this monstrosity. They did nothing to prevent it, and insisted that all people have an insurance company between them and their health care. This sits squarely in the laps of everyone that voted for and defended this monstrosity. One little tiny public OPTION could have changed all this. But Obama wouldn't even CALL the Senator from Aetna. But he did go and fly to Dennis' district to lobby him to vote for it.

It's called Obamacare for a reason.

[ProSense]

37. You mean,

"Yes, his and the senators that set up this monstrosity."

...the "monstrosity" that will save people money (despite your defense of Aetna's BS threat)?

http://www.democraticunderground.com/10022804988

...the "monstrosity" that strengthened Medicare: http://www.democraticunderground.com/?com=view_post&forum=1002&pid=2670334

...the "monstrosity" that expanded Medicaid to more 17 million more Americans: http://www.democraticunderground.com/10022456901

This "monstrosity":

Editorial

Report Card on Health Care Reform

By THE EDITORIAL BOARD

Republican leaders in Congress regularly denounce the 2010 Affordable Care Act and vow to block money to carry it out or even to repeal it. Those political attacks ignore the considerable benefits delivered to millions of people since the law’s enactment three years ago Saturday. The main elements of the law do not kick in until Jan. 1, 2014, when many millions of uninsured people will gain coverage. Yet it has already thrown a lifeline to people at high risk of losing insurance or being uninsured, including young adults and people with chronic health problems, and it has made a start toward reforming the costly, dysfunctional American health care system.

EXPANDING COVERAGE Starting in 2010, all insurers and employers that offer dependent coverage were required to offer coverage to dependent children up to age 26. An estimated 6.6 million people ages 19 through 25 have been able to stay on or join their parents’ plans as result, with more than 3 million previously uninsured young adults getting health insurance. The law requires private health insurers to provide free preventive care, without co-pays or deductibles. Some 71 million Americans have received at least one free preventive service, like a mammogram or a flu shot, and an additional 34 million older Americans got free preventive services in 2012 under Medicare.

<...>

The law appropriated $11 billion over five years to build and operate community health centers, a major factor in increasing the annual number of patients served to 21 million, a rise of 3 million from previous levels. Some $5 billion has been put into a reinsurance program that has encouraged employers to retain coverage for retirees and their families; 19 million people benefited with reduced premiums or cost-sharing.

<...>

BETTER QUALITY OF CARE One of the most promising aspects of the health reform act is its focus on improving quality. The percentage of Medicare patients requiring readmission to the hospital within 30 days of discharge dropped from an average of 19 percent over the past five years to 17.8 percent in the last half of 2012, an improvement due in large part to penalties imposed by Medicare for poor performance and financial incentives paid by Medicare to providers to encourage better coordination of care after a patient leaves the hospital.

- more -

http://www.nytimes.com/2013/03/24/opinion/sunday/report-card-on-health-care-reform.html

Here's a summary of the NYT report:

That includes:

• Some 6.6 million people ages 19 through 25 who have been able to stay on their parents' insurance plans and more than than 3 million young adults getting health insurance.
  
  
• 17 million getting some kind of free preventive service, like flu shots, and 34 million Medicare recipients getting free preventive services in 2012;
  
  
• 17 million children with pre-existing conditions being protected against being uninsured;
  
  
• More than 107,000 adults with pre-existing conditions finally having insurance under the federally run insurance program;
  
  
• 21 million received care from expanded community health centers, 3 million more than previously served;
  
  
• $1.1 billion in rebates, an average of $151 per family paid by insurers that failed to meet the benchmark of 80 to 85 percent of premium revenues on medical claims or quality improvements;
  
  
• Since 2010, more than 6.3 million older or disabled people have saved more than $6.3 billion on prescription drugs;

- more -

http://www.dailykos.com/story/2013/03/25/1196892/-An-Affordable-Care-Act-report-card-three-years-in

...this "monstrosity":

Vermont also intends to be the first state in the U.S. with a single-payer health-care system, in which the government pays all of its residents’ medical bills and insurance companies are unnecessary. The state legislature passed a law in 2011 to steer the state toward adopting such a system in 2017, the soonest possible under the federal health-care law.

http://www.bloomberg.com/news/2013-04-01/vermont-s-first-look-at-insurance-exchange-rates-shows-savings.html

"It's called Obamacare for a reason."

Yup: http://www.democraticunderground.com/10021303316

Why Republicans are So Intent on Killing Health Care Reform

by Richard Kirsch

It’s not just about expanded care. It’s about proving our government can be a force for the common good.

Why are John Boehner, Eric Cantor and Mitch McConnell so intent on stopping health care reform from ever taking hold? For the same reason that Republicans and the corporate Right spent more than $200 million in the last year to demonize health care in swing Congressional districts. It wasn’t just about trying to stop the bill from becoming law or taking over Congress. It is because health reform, if it takes hold, will create a bond between the American people and government, just as Social Security and Medicare have done. Democrats, and all those who believe that government has a positive place in our lives, should remember how much is at stake as Republicans and corporate elites try to use their electoral victory to dismantle the new health care law.

My enjoyment of the MLB playoffs last month was interrupted by ads run by Karl Rove’s Crossroads front group against upstate New York Rep. Scott Murphy, who was defeated last Tuesday. Rove’s ads rained accusations on Murphy, including the charge of a “government takeover of health care.” Some might have thought that once the public option was removed from the health care legislation, Republicans couldn’t make that charge. But it was never tied to the public option or any other specific reform. Republicans and their allies, following the advice of message guru Frank Luntz, were going to call whatever Democrats proposed a government takeover.

There’s nothing new here. Throughout American history, health care reform has been attacked as socialist. An editorial published in the Journal of the American Medical Association in December 1932, just after FDR’s election, claimed that proposals for compulsory insurance “were socialism and communism — inciting to revolution.” The PR firm that the American Medical Association hired to fight Truman’s push for national health insurance succeeded in popularizing a completely concocted quote that it attributed to Vladimir Lenin: “Socialized medicine is the keystone to the arch of the Socialist State.”

<...>

President Obama and Democrats in Congress understood the historical importance and profound moral underpinnings of the new health care law when they enacted it earlier this year. And they knew that the right-wing attack had soured the public in swing Congressional districts and states on reform. They stood up then. They will have to stand up again, understanding that if they give way to Republicans, they lose more than the expansion of health coverage. They lose the best opportunity in half a century to prove to Americans that government can be a force for the common good.

http://www.nextnewdeal.net/why-republicans-are-so-intent-killing-health-care-reform

[zipplewrath]

38. Yes

That one, the one that puts profits and profit making companies between me and my health care.

That's the one.

[ProSense]

39. Wait,

"That one, the one that puts profits and profit making companies between me and my health care."

...I though Aetna's point was the the exchanges aren't going to be "profitable" enough?

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=2806127

I mean, no one will miss the insurance companies if they pack up and go home, and if that is a consequence of Obamacare, rejoice!

[zipplewrath]

40. Some won't be

Some will. I'll be in one of the ones that will. Many MANY states/exchanges will be. Aetna will be in those. And the mandate requires that I go through an insurance company to get health care. It makes no requirement that there be a non-profit available. Quite the opposite, it is very likely that in the small markets, there will only one or two companies at all. With a little luck, the smaller states will be able to pool their exchanges to attract more profit making companies.

[ProSense]

41. Are you saying

"Some won't be...Some will. I'll be in one of the ones that will. Many MANY states/exchanges will be. Aetna will be in those. And the mandate requires that I go through an insurance company to get health care. It makes no requirement that there be a non-profit available. Quite the opposite, it is very likely that in the small markets, there will only one or two companies at all. With a little luck, the smaller states will be able to pool their exchanges to attract more profit making companies."

...some exchanges will be profitable and "Aetna will be in those"? You said they would be in the "large markets" (http://www.democraticunderground.com/?com=view_post&forum=1002&pid=2805856), but a large market like NY will produce big savings on premiums: http://www.democraticunderground.com/10022804988

On the point of a "non-profit," you need to check the facts.

<...>

While Cigna will continue providing insurance to large businesses, it has not proposed any plans for the exchange. The member-owned Vermont Health Co-op, on the other hand, would sell insurance on the exchange, if the state approves its application for a license. The co-op has already received its federal health insurers’ license and has filed proposed rates with the Department of Vermont Health Access, but it cannot propose rates to the Department of Financial Regulation until it obtains a state license.

http://vtdigger.org/2013/04/01/state-releases-proposed-premium-rates-for-health-insurance-exchange/

New Loan Program Helps Create Customer-Driven Non-Profit Health Insurers
http://cciio.cms.gov/archive/grants/new-loan-program.html
http://cciio.cms.gov/resources/factsheets/coop_final_rule.html

And in some large markets, there are "government-run public plans"

In 2014, under the federal health overhaul law, millions of Americans will be able to buy coverage through state-based insurance exchanges. In California, government-run public plans, like the Alameda Alliance for Health, will go head-to-head with private insurance companies to compete for all those new customers, and those who run the county plans believe they can offer a robust network of doctors and hospitals to bargain shoppers looking for low-cost coverage.

http://www.democraticunderground.com/1002197452

In many states, including many of the small markets, the federal government will run the exchanges. So Aetna can play by the rules or get kicked to the curb or pack its bags and go home.

[zipplewrath]

43. I said what I meant

Despite your repeated attempts to ignore it. Aetna was very clear in what they said. They said that if they can't get the margins they need/want, they will drop out of pursuing markets. They anticipate that this will be in markets in which they currently don't have existing pricing data. Predominately because they will rely upon "commercial" pricing in those markets. If the exchanges can form in a way that will create sufficient profit potential, they will pursue it. Smaller markets probably won't fit that business model. If they can form into larger exchanges where Aetna has sufficient pricing data, Aetna will pursue those exchanges. Small markets would do well to try to coordinate with large ones. That will reduce Aenta's risk in those exchanges and offer a better chance of attracting them to those markets.

This is the system Obama created.

Nothing in the ACA requires any exchange to have nonprofits. It does require everyone to obtain their health care THROUGH an insurance company, whether there are nonprofits available or not.

[ProSense]

44. And

I said what I meant

Despite your repeated attempts to ignore it. Aetna was very clear in what they said. They said that if they can't get the margins they need/want, they will drop out of pursuing markets. They anticipate that this will be in markets in which they currently don't have existing pricing data. Predominately because they will rely upon "commercial" pricing in those markets. If the exchanges can form in a way that will create sufficient profit potential, they will pursue it. Smaller markets probably won't fit that business model. If they can form into larger exchanges where Aetna has sufficient pricing data, Aetna will pursue those exchanges. Small markets would do well to try to coordinate with large ones. That will reduce Aenta's risk in those exchanges and offer a better chance of attracting them to those markets.

This is the system Obama created.

...I said what I meant: Rejoice!

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=2806487

[Sheepshank]

42. Just a sec...

how is this threat of pulling out of a market, any different than the current trend of companies that refuse to put in a bid at XXX Company because of the health history of the employees? is that Obama's fault too? How about historic trends for unhealthy states and cities...don't you think that would play into the profitability equations?

I work at a local government agency, and Aetna and BC/BS refuse to even enter into an RFP. I don't know how this is any different than the politicized statement in the OP.

[zipplewrath]

48. Are their customers mandated?

Answer this simple question. Did the federal government mandate that your local agency deal with an insurance company? Who is responsible for forcing everyone to go through an insurance company to get health care?

[Sheepshank]

49. This was about their perceived need for $XXX profits, no?

what does have to do with any mandate. They choose to participate or not. They choose to file a bid or not. I seriously don't see why there is any concern here. Their choice...right?

[zipplewrath]

51. The profit motive has always been there

Obama made it a requirement that we all deal with an insurance company to get access to health care.

You can't claim to love Obamacare, and complain about exposing us to for profit health insurance. There are no explicit protections against being exposed to them to get health care. If one is lucky enough to be in a state/market that has nonprofit, so be it. But when Obama dumped the public option, but kept the mandate, he bought into (excuse the pun) the idea that people would be forced to work with companies like Aetna. (Him and the Senator from Aetna).

[sabrina 1]

46. Don't worry, this is just a temper tantrum which will be effective. Congress will fix it for them

at the expense, once again, of the American people.

This is why the HC 'Debate' which actually saved the Private Insurance Industry by passing public funds through their hands and for which they should be eternally grateful, was never going to be enough for them.

I fully expect them to get what they want. Unless the people become so engaged, so outraged, so willing to end this HC For Profit system we have that Congress finally becomes too scared to cater to them anymore.

[graham4anything]

2. I dropped Aetna a few months ago. Saved $19,200 a year thanks to President Obama's plan.

and most states won't see it til Jan. 2014.
NJ is one of the early ones.
Couldn't change in 2012.
In 2013, was able to, same insurance, same NO lifetime cap and prior existing did NOT matter and all is included in new one.

[enough]

6. Can you say a bit more about how this worked? What was the process?

Thanks.

[graham4anything]

7. ok

in 2012 around March, I looked all over for new insurance

self employed, family plan paying aetna $2960 a month with a 50/50 deductible
2013 they wanted $3100

2012-looked all over, NONE were available in 2012 that didn't exclude prior illness so that let us out

looked this year, most were NOT available, but Horizon was.
2013 1500approx. a month, NO exemptions, NO lifetime cap and it's 70/30 after deductible with same dollar amount.
Out of pocket just on premium savings of $19,000plus plus if we are ill, we have more savings out of pocket from the 70/30 instead of 50/50 til the amount is made.
At which point 100% is covered.
All our current doctors are covered on new plan, and we don't have to use their doctors,but their doctors are included anyhow as are all the hospitals and specialists around here.

And this includes the hospital stay I had a year ago and the reasons for it.

it indeed is a straight out of pocket savings of more than $19000.

Yes, it is still expensive, but one must have insurance.

and there were even cheaper plans if one wanted a full hmo type plan, again, last year we didn't qualify, this year we did.
Because the smart companies are complying and doing so earlier.

[enough]

17. Thanks for spelling this out. That is really an amazing savings.

You have been smart to search pro-actively each year.

[Recursion]

3. That's the idea

We hope so, at least. That's why there has to be a not for profit option in every state.

[OneGrassRoot]

4. Exactly. "Not profitable enough"

"enough" being the key word.

Wonder what his annual salary is?

Healthcare should not be for profit.

Ugh.

[graham4anything]

8. one must include doctors in that statement too.

there should be a limit on what doctors charge.

Why does everyone blame everyone except the doctor?

[hobbit709]

10. Doctors have to charge that much so that the insurance company pays them enough.

The insurance companies only pay a fraction of the "usual and customary" charge. They have to make the charge high enough so that the 30% or so of the charge that the insurance company actually pays covers the doctor's expenses. The doctors are getting screwed by the insurance companies as much as the patients.

[OneGrassRoot]

11. I don't think "everyone" does.

Hobbit replied with one fact with regard to doctors' salaries.

That said, I think some doctors, especially those in certain specialties, charge exorbitant fees and manipulate the system, whereas others are more in alignment with running their practice with integrity.

Not sure the integrity approach can be applied to many of the insurance company or Big Pharma CEOs.

[KentuckyWoman]

5. a nice dream

all the "profits over people" companies pull out and everyone ends up in either medicare or a non profit..

[Quantess]

9. Health insurance companies are unnecessary parasites.

Our system is designed for health insuance companies, though.

[sabrina 1]

47. Exactly, nothing but Middlemen who drain money from the HC providing nothing in actual HC

as their sole function is profit. How we ever got here is the mystery. The logic of such a system boggles the mind.

Let's HOPE they all quit, which I seriously doubt will happen. My expectation is that they will use their money and influence on Congress to get what they want. They were saved from extinction when the PO was dropped and Congress spent its energy trying to provide profits for THEM. We all knew that would not be enough, and here is the beginning of them trying to 'fix' the problem of more profits for a useless, inept, unnecessary group of 'providers'. We don't need them, let them fade away into the oblivion they belong in. And then let's get a National HC system like every other civilized nation.

[cantbeserious]

12. For Profit Health Care Will Never Be Affordable

eom

[KrazyinKS]

13. Aetna gets bad reviews

If you go out shopping for health insurance for yourself, and go over customer reviews, Aetna gets terrible reviews. My daughter and son-in-law had Aetna through his work. They have had multiple health issues, its just been one thing after another. Devastating stuff-Aetna decides they just don't want to pay for chemo/ Yeah they had a 9 month old with neuroblastoma. We have one pediatric oncologist in town, just one-so that is who they went to. Of course Aetna doesn't want to pay for that and other things. They had a huge bill. Aetna really does suck big time.

[L0oniX]

26. ...and if they pay out ...you will have to pay them back if you get any money from anyone else.

[magical thyme]

14. they learned from the TBTF Banks

Here we go. Another round of extortion.

Of course, the right response would be to let them go and when all the TBTF insurance companies sit down and refuse, offer a public option instead.

But we know that won't happen.

[SoCalDem]

16. Aetna sucks..good riddance

[geek tragedy]

21. Aetna has always been the worst of the worst of junk insurance peddlers.

A really vile, evil, bloodsoaked company. There are no angels in the health insurance industry, but these guys are known for ruthlessly denying coverage and committing murder by spreadsheet in order to market themselves as a cheap option to employers who look to save a dime.

[hobbit709]

33. NYLCare was bad, then Aetna bought them out.

I had them once. What a pain to get anything done.

[ileus]

22. once they all drop out we'll be on the road to single payer.

[L0oniX]

25. Aetna is NOT an insurance corporation by any meaning of the word insurance...

unless you are quadriplegic. They will fight you to the bitter end for short term and long term. If you get ANY settlement from ANY other source they will make you pay them back. Other sources include SSDI, your auto insurance (you'll have to fight them too even if it was not your fault), inheritance, lotto, you name it! I hate them with all the fires of hell ...and I hope there is a special hell just for them fucking sociopathic monsters!

[cbdo2007]

27. Good, then in good capitalistic spirit they will be crushed and go out of business.

[elleng]

30. Let them go!

Sorry, a 'prejudice.' I'm a retired Federal employee, have had Blue Cross/Shield for years, and whenever we looked during Open Season at our options, Aetna was ALWAYS overpriced.

[lumberjack_jeff]

31. As the insurers who "sort of favor margin over membership" drop out

it becomes a quasi single payer system.

If only one insurer is in the exchange, they have the economies of scale working in their members favor, and government has only one regulatory target who is dependent on government's business.

[supernova]

32. They say that as if we care...

[LiberalFighter]

45. Where will they go?

There options will be employer provided insurance that also has restrictions with medical loss ratio enforced or the exchange.

So they want to reduce their options???

[steve2470]

50. Fuck Aetna with a rusty chainsaw

I won't cry any tears when we finally go to Medicare for all and they go belly up in the health insurance business.