Aetna last of the five health insurers to project a loss on Obamacare plans

Health insurer’s moves underscore concerns about stability of insurance marketplaces.

Aetna said it would re-evaluate its participation in the 15 state exchanges where it currently sells plans, and cancel a planned expansion into more.

Aetna said it would re-evaluate its participation in the 15 state exchanges where it currently sells plans, and cancel a planned expansion into more.

Aetna Inc. became the last of the five major national health insurers to project a loss on Affordable Care Act plans for 2016, underscoring concerns about the stability of the insurance marketplaces at the heart of the Obama administration’s signature health law.

Aetna said it would re-evaluate its participation in the 15 state exchanges where it currently sells plans, and cancel a planned expansion into more.

The moves come in the wake of recent confirmations by UnitedHealth Group Inc. and Humana Inc. that they would pull back sharply from the ACA’s exchanges amid deepening losses, and a disclosure by Anthem Inc. that it now expects losses on its ACA business in 2016.

“We will look at the financial performance of the business over time, its trajectory and volatility” and the review will be market-by-market, said Aetna Chief Executive Mark T. Bertolini.

Aetna’s options in each county would include sharply limiting the plans it offers there, completely exiting, or remaining fully engaged, he said. Aetna will need to begin making initial decisions by next week because of regulatory deadlines, he said.

Aetna had earlier made regulatory filings indicating it was considering expanding into five new state exchanges in 2017. In at least one of those states, Oklahoma, Aetna’s decision not to come in, along with the earlier announced pullout of UnitedHealth, means there will be just one exchange insurer statewide next year, a spokeswoman for the state insurance regulator said. Other states, such as Alaska and Alabama, were already expected to move to having just one marketplace insurer next year.

The dynamic is worrisome for some state regulators. “As a general rule, more companies, and more competition, is better,” said Mark Fowler, chief of staff at the Alabama Department of Insurance. Humana and UnitedHealth will no longer sell exchange plans in the state next year, leaving only Blue Cross and Blue Shield of Alabama.

Obama administration officials said the exchanges are generally thriving, amid ongoing regulatory moves to strengthen them. “The marketplace continues to grow, and there are companies making money,” said Kevin Griffis, Assistant Secretary for Public Affairs at the Department of Health and Human Services.

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