Aetna withdrawal puts spotlight back on ACA

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The announced withdrawal of health insurance giant Aetna from Obamacare exchanges this week has put the healthcare law back in the thicket of political debate.

Aetna announced early this week it would pull out of Affordable Care Act health insurance exchanges in close to 550 counties in 11 states, causing consternation in numerous states, particularly Texas and Arizona. But in a Huffington Post piece, reporters found evidence that Aetna would withdraw if the merger with Humana fell apart. The letter the reporters obtained, from Aetna Mark T. Bertolini Chairman and CEO, states, “if the DOJ sues to enjoin the transaction, we will immediately take action to reduce our 2017 exchange footprint.”

In Aetna's public statement on the withdrawal, Bertolini wrote, “As a strong supporter of public exchanges as a means to meet the needs of the uninsured, we regret having to make this decision. Providing affordable, high-quality healthcare options to consumers is not possible without a balanced risk pool.”

The debate could lead Republicans to once again attempt to scrap the legislation next year, or for Democrats to tweak it. Politicians weighed in this week on what Aetna's decision meant, with GOP presidential candidate Donald J. Trump tweeting it was “only the beginning.” On the Democratic side, Sen. Bernie Sanders (I-VT) said he would reintroduce a single-payer bill in the next Congress, “hopefully as part of the Democratic Senate majority,” according to The Hill.

In an opinion piece, the New York Times editorial board wrote said that while it was reasonable to expect tweaks to the ACA, the Aetna decision in no way signaled the law's death. Democratic presidential candidate Hillary Clinton has said she wants to expand coverage, and criticized the Aetna/Humana and Anthem/Cigna merger last fall.