Aetna: Late Obamacare changes account for half of 2015 premium increases


Aetna CEO Mark Bertolini (Andrew Harrer/Bloomberg)

Major health insurers are starting to report their first quarter of financial results under Obamacare's new market rules, giving us some perspective on how they're seeing the law's new insurance marketplaces playing out. It was Aetna's turn Thursday morning, a week after UnitedHealth Group reported its results.

Here are some highlights from the Aetna call:

1. The nation's third-largest health insurer is participating in 17 state Affordable Care Act exchanges in 2014. The company says its "bias" is to stay at that level in 2015.

2. Aetna chief executive Mark Bertolini says premium increases in those 17 states, which encompass 132 rating areas, will be quite literally all over the map in 2015. He said those increases will range from "the very low single digits" to "some that will be over double digits." That depends on the number of members, the demographics of memberships and what limited information the company has about new members, he said.

3. Bertolini said about half of the company's premium increases, whatever they turn out to be, will be attributable to "on the fly" regulatory changes made by the Obama administration. He cited as an example the administration's policy of allowing old health plans that were supposed to expire in 2014 to be extended another three years if states and insurers wanted to.

4. The individual market, both in the exchanges and off the exchanges, makes up about 5 percent of Aetna's operating revenues in 2014. So the market for insuring individuals — as opposed to the market for insuring groups of employees — is just a small part of Aetna's business.

5. Aetna has added 230,000 paying customers from ACA exchanges, and it projects to end the year with 450,000 paid customers. It said it can't yet draw a "meaningful conclusion" about the population's overall health status. In January, Bertolini said the early enrollment mix had looked better than he expected.

6. Bertolini also said the company withdrew from some markets in 2014 where the company would have to compete with new co-ops funded by the ACA. The nonprofit health plans were included in the law to drive down competitors’ prices, so it’s interesting that Aetna decided to stay away.

Jason Millman covers all things health policy, with a focus on Obamacare implementation. He previously covered health policy for Politico.
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