Page 25 - Aruba Today
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BUSINESS A25
Tuesday 2 February 2016
Insurer Aetna lays out concerns about ACA exchange business
TOM MURPHY In this Oct. 6, 2015, file photo, the HealthCare.gov website, where people can buy health in- to use special enrollment
AP Business Writer surance, is displayed on a laptop screen in Washington. Aetna has joined other major health periods to shop for cover-
Aetna has joined other ma- insurers in sounding a warning about the Affordable Care Act’s public insurance exchanges. age if they lose their insur-
jor health insurers in sound- ance for more common
ing a warning about the Af- Associated Press reasons like a move, a mar-
fordable Care Act’s public riage or divorce or the loss
insurance exchanges. they know they need it ment. publicly supported the ex- of a job.
The nation’s third-largest and then drop it when they “We continue to have se- changes in the past, say But the government plans
insurer said Monday that know they don’t,” Chief rious concerns about the they are still committed to clarify guidelines on
it has been struggling with Financial Officer Shawn sustainability of the public and not ready yet to make those remaining windows
customers who sign up Guertin told The Associat- exchanges,” Aetna Chair- that kind of call. so customers understand
for coverage outside the ed Press. man and CEO Mark Berto- “It would be premature them better. That includes
ACA’s annual enrollment The Centers for Medicare lini said Monday. frankly to declare victory or clarifying that an enroll-
window and then use a lot and Medicaid Services Blue Cross-Blue Shield insur- defeat at this stage in the ment period cannot be
of care. This dumps claims recently outlined sever- er Anthem Inc. also is pay- process,” Guertin said. used for a temporary
on the insurer without pro- al changes it said it was ing close attention to how Federal officials an- move, and people who do
viding enough premium making to help shore up the government deals with nounced last month that not provide accurate infor-
revenue to counter those exchange enrollment win- special enrollment periods they would end several mation on their insurance
costs. dows. as it judges how sustain- narrow special enrollment application could be pe-
The ACA provides an annu- Aetna is a big player in able the exchange busi- windows that focused on nalized.
al enrollment window that the ACA’s state-based ex- ness will be in the future, consumers like non-citizens HealthCare.gov CEO Kevin
gives people several weeks changes. It has enrolled CEO Joseph Swedish said with incomes below the Counihan said in a Jan. 19
starting every fall in which about 750,000 people and recently. federal poverty level who blog post that special en-
they can buy coverage is selling coverage in 15 UnitedHealth Group has experienced processing rollment periods will not
for the next year. The law states this year. It lost more said it will decide this year delays. be available for “the vast
established that window to than $100 million last year whether to participate in Customers will still be able majority of consumers.”
prevent people from wait- on its exchange business, the public exchanges in HealthCare.Gov operates
ing until they become sick which makes up a small 2017. public insurance exchang-
to buy insurance. But insur- part of its overall enroll- Aetna leaders, who have es in 38 states.
ers say it has become too “For example, special en-
easy for customers to sign rollment periods are not
up outside of this window. allowed for people who
Customers are allowed to choose to remain unin-
buy coverage outside that sured and then decide
time frame if they lose a they need health insur-
job, get divorced or have ance when they get sick,”
a child, among other rea- he wrote.
sons. Insurers want the fed- Insurers are also making
eral government, which adjustments. Aetna has left
processes coverage appli- exchanges in markets like
cations in 38 states, to take Kansas where it incurred
a closer look at whether high costs. It also has raised
people actually qualify for rates and done other
these special enrollment things to shore up a busi-
periods when they apply ness that only contributes
for coverage. about 5 percent of its total
Both Aetna and United- enrollment.q
Health Group Inc. said the
exchange customers they
get outside the annual en-
rollment window use more
health care than those
who sign up within it. This
includes some cases where
it appears that a customer
bought coverage, used it
and then dropped it.
“Insurance systems tend to
get stressed when people
can buy coverage when
