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Government Texas losing Aetna Affordable Care Act insurance exchanges

Texas losing Aetna Affordable Care Act insurance exchanges

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DALLAS (AP) — Aetna will abandon Affordable Care Act insurance exchanges next year in Texas and 10 other states amid financial concerns.

The nation’s third-largest insurer has not released specifics on how many clients in Texas use the exchange. But in rate increase filings, Aetna reported about 84,000 customers in the individual marketplace in Texas. And 1.1 million Texans were enrolled in the federal exchange as of March 31, according to the Centers for Medicare and Medicaid Services.

Aetna announced late Monday that a second-quarter pretax loss of $200 million from its individual insurance coverage helped it decide to limit exposure to the exchanges. Aetna also reported having total pretax losses of more than $430 million since January 2014.

The announcement came several weeks after UnitedHealth and Humana also said they would cut their coverage plans for 2017 and after more than a dozen nonprofit insurance co-ops have shut down in the past couple of years.

“We regret having to make this decision,” Aetna chairman and CEO Mark T. Bertolini said in a statement. “Providing affordable, high-quality health care options to consumers is not possible without a balanced risk pool.”

Experts say it’s too soon to determine how shrinking insurer participation will affect rates beyond next year. Under state law, insurance companies must give consumers at least 90 days notice before discontinuing a plan in the individual market.

“These changes do not affect coverage for the 2016 plan year,” Aetna spokeswoman Anjie Coplin told the Austin American-Statesman. “We will communicate options to impacted members before the 2017 open enrollment period begins, and provide resources to assist them in transitioning to other plans as appropriate.”

Lance Lunsford, spokesman for the Austin-based Texas Hospital Association said “ultimately, any loss of integrity to the options or programs in the health insurance marketplace is problematic in Texas (as) a whole since we have the highest uninsured rate in the nation.”

The enrollment period for 2017 coverage starts Nov. 1.

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