{"database": "press", "table": "releases", "rows": [["http://degette.house.gov/media-center/in-the-news/aetna-decision-exposes-weaknesses-in-obama-s-health-care-law", "Aetna Decision Exposes Weaknesses in Obamas Health-Care Law", "2016-08-17", "2016", "2016-08", "Democrat", "House", "CO", "Diana DeGette", "D000197", "degette.house.gov", null, null, "legacy", "Insurance giant Aetna\u2019s decision to stop offering much of its individual coverage through the Affordable Care Act is exposing a problem in President Obama\u2019s signature health-care law that could lead to another fraught political battle in Congress.\nAetna\u2019s announcement Monday night was the latest sign that large insurers are losing money in the Affordable Care Act\u2019s marketplaces, heightening concerns about the long-term stability of a key part of Obama\u2019s domestic policy legacy. But addressing this issue could open the door to a nasty political fight, given that some Republicans have vowed to repeal the law outright.\nIf insurers continue to lose money, more are likely to withdraw from the marketplaces, a move that would reduce choices for consumers and could contribute to higher premiums. In one county, Aetna\u2019s exit in 2017 could leave no insurers offering policies through its marketplace.\nAetna said it will exit 11 of the 15 states where it offers coverage through the Affordable\u00a0Care Act, widely known as Obamacare. That affects about 80\u00a0percent of its customers covered through insurance marketplaces.\nThe marketplaces, known as insurance exchanges, were created to provide coverage for Americans who cannot get affordable health benefits through a job. A key aspect of the health-care law, the marketplaces allow people to purchase insurance online with subsidies based on their income.\nEarlier this month, Humana said it will cut back its participation on the exchanges from 15 states to 11. On an earnings call in July, UnitedHealth Group chief executive Stephen Hemsley announced that his company plans to remain on \u201cthree or fewer exchange markets.\u201d\nIn a reversal of expectations, Anthem said it is projecting mid-single-digit losses on the individual plans it sells on the exchanges for 2016. And Cigna has said that it is losing money on the exchanges, although the insurer is planning to expand its marketplace presence to three new states in 2017.\nThe health-care law is likely to prompt another heated political battle, regardless of which party wins the White House and control of Congress in November.\nGOP presidential nominee Donald Trump has suggested that he would seek to scrap it altogether. Quoting a news story by Reuters on Tuesday, he tweeted: \u201cAnother health insurer is pulling back due to \u2018persistent financial losses on #Obamacare plans.\u2019 Only the beginning!\u201d\nDemocratic nominee Hillary Clinton has pledged to modify the law to expand coverage and wants to add a public insurance option.\nBoth candidates\u2019 proposals would face stiff political headwinds, but several health-care experts said lawmakers could still pursue more modest changes to make the program work better.\n\u201cThe idea of somehow repealing it is far-fetched,\u201d said Joseph Antos, a resident scholar at the American Enterprise Institute. \u201cBut changing it is not far-fetched.\u201d\nThere are many possible policy remedies, but the main issues have to do with the risk pool \u2014 the balance between healthy people and sick people with higher health-care expenses. Many insurers have noted that people who have signed up for health insurance on the marketplaces are sicker, putting greater demands on the system.\n\u201cYou have here a situation which all of us who care about the exchanges have to worry about,\u201d said Zeke Emanuel, who served as a top White House health policy adviser during Obama\u2019s first term and is now vice provost for global initiatives at the University of Pennsylvania. \u201cThere is a problem with the risk pool. There is a problem with the numbers of people signing up.\u201d\nOne solution would be to entice more people \u2014 particularly healthy ones \u2014 to sign up for insurance, whether through a more robust public outreach campaign or by warning them about escalating financial penalties for not having coverage. Another would be to find new and better ways to give insurers that cover the sickest people greater financial relief.\n\u201cThere are incremental steps the administration can take to address that, but I think more significant changes would require legislation that could get bipartisan support,\u201d said Mark McClellan, director of the Margolis Center for Health Policy at Duke University.\nIn a statement Tuesday, Clinton spokesman Jesse Ferguson said the candidate is committed to expanding the law, which Obama signed in 2010.\n\u201cHillary Clinton has outlined concrete plans to make health coverage more affordable in and out of the marketplaces, with more choices, expanded relief for costs, aggressively containing prescription drug expenses and the choice of a public option,\u201d he said.\nMany of these initiatives, along with any move to stiffen the financial penalties for not purchasing insurance, would require congressional approval.\nIn the meantime, however, some insurers are pulling back \u2014 and at least one county in Arizona has no insurers slated to sell marketplace plans in 2017.\nAetna chief executive Mark Bertolini said in a statement that there are not enough healthy people to financially offset those with major health problems who require high-cost care. As of June 30, Aetna covered 838,000 people through the exchanges. In total,\u00a011.1\u00a0million people\u00a0were signed up for the marketplace plans at the end of March.\nKatherine Hempstead, a senior adviser at the Robert Wood Johnson Foundation, said that these national carriers haven\u2019t traditionally been the biggest part of the exchanges.\n\u201cI think the market could survive without these guys,\u201d she said. \u201cObviously, it would be better to see lots of people seeing a lot of opportunity in this space. .\u2009.\u2009. But I don\u2019t think it\u2019s a chapter in a Greek tragedy.\u201d\nThe decisions also come as four of the major insurers are in a battle with the Obama administration. The Justice Department has blocked two proposed mergers: between Aetna and Humana, and between Anthem and Cigna. The companies are fighting the decisions.\nAnthem has said that if its proposed deal with Cigna is allowed to go through, it will increase its exchange offerings to nine additional states.\nCaroline Pearson, a senior vice president at Avalere Health, a health-care consulting firm, said that the lawsuit may have affected the timing of Aetna\u2019s announcement \u2014 in late April, Bertolini described the marketplace as \u201ca good investment\u201d \u2014 but not the underlying facts about the viability of the marketplaces.\nHouse Energy and Commerce Committee Chairman Fred Upton (R-Mich.) said in a statement that the administration deserves the blame. \u201cPlans are rapidly exiting the so-called marketplace because Washington has damaged and upended the insurance markets,\u201d he said.\nBut Rep. Diana DeGette (Colo.), the top Democrat on Energy and Commerce\u2019s subcommittee on oversight and investigations, said in an interview Tuesday that Republicans \u201cseem to be hell-bent\u201d on holding hearings \u201cto support their multitude of efforts to repeal the ACA\u201d and \u201chave totally neglected their duty to try to fix it.\u201d\nDeGette said multiple senior and influential Republicans have told her privately that they are open to tweaking the health-care law after the November elections, when they have a clearer sense of the new political landscape.\n\u201cThere\u2019s a long list of things large and small that need to be adjusted,\u201d she said. \u201cBut I don\u2019t think anyone can say what that is until we know what the new Congress looks like.\u201d", 1, "2026-03-30T12:14:52Z", "2026-03-30T12:14:52Z"]], "columns": ["url", "title", "date", "year", "month", "party", "chamber", "state", "member_name", "bioguide_id", "domain", "scraper", "source", "date_source", "text", "has_text", "collected_at", "updated_at"], "primary_keys": ["url"], "primary_key_values": ["http://degette.house.gov/media-center/in-the-news/aetna-decision-exposes-weaknesses-in-obama-s-health-care-law"], "units": {}, "query_ms": 1.8240369390696287, "source": "dwillis/congress-press", "source_url": "https://github.com/dwillis/congress-press", "license": "MIT", "license_url": "https://github.com/dwillis/congress-press/blob/main/LICENSE"}