Trump, Clinton speak out on Aetna’s ACA departure

The leading candidates had vastly different views on what the insurer’s defection means, and how to improve the health insurance industry

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So far a little discussed issue in the 2016 presidential election, health insurance is suddenly off the backburner and on the lips of the leading candidates for the White House.

Aetna Inc.’s announcement earlier this week that it will slash about 70% of what it offers on the Affordable Care Act exchanges has drawn strong – albeit vastly different – responses from both Donald Trump and Hillary Clinton.

The insurer’s move follows a $200 million loss in the second quarter, which it attributes to its participation in the ACA marketplace. Similar decisions have already been made by UnitedHealth and Aetna’s potential acquisition target, Humana, which said last month it would pull out of some markets, cut plans and raise rates.

Speaking at a rally in Wisconsin Tuesday, Trump called the series of departures evidence that the ACA is a “broken law” and “slowly imploding under its regulatory red tape.”

“Aetna just today announced that they are dropping out, as are many of the major insurance agencies,” Trump said. “Obamacare is a disaster.”

The Republican nominee underlined his pledge to repeal the legislation, eliminate the individual mandate, roll back the Medicaid expansion and create a national market by allowing insurers to sell policies across state lines.

“We will have alternatives that will be so good, so much less expensive, so much better that you will actually be able to keep your doctor and have your plan. That was the biggest lie of all of them,” Trump said this week. “Premiums are going up 45% to 55% and we are just going to do something and it’s going to be great. We’re going to end up having great, great healthcare.”

The situation in which Aetna pulled out of the ACA exchanges has some Democrats skeptical, however. Evidence emerged shortly after Aetna’s announcement that its exit may have been follow-through on a threat issued earlier in the year by Chief Executive Mark Bertolini.

In a letter sent to federal antitrust officials in July, Bertolini said Aetna would abandon the exchanges if the US Justice Department moved to block its planned acquisition of rival Humana. Obtained by the Huffington Post through the Freedom of information Act, the letter said that a challenge by the DOJ to the acquisition “would have a negative financial impact on Aetna and would impair Aetna’s ability to continue its support, leaving Aetna with no choice but to take actions to steward its financial health.”

Though Clinton has not commented directly on Bertolini’s statements, she used Aetna’s departure as a chance to renew her pledge to “defend and improve” the Affordable Care Act, in part by setting limits on out-of-pocket costs and supporting a public insurance option.

A public option, in which the government would compete directly with private insurers, would boost choice in markets that groups like Humana and Aetna have exited, Clinton stressed.

This is a way of “giving Americans, in every state, a choice of a public option health insurance plan that will help everybody afford coverage,” she said this week. “It will strengthen competition and drive down costs.”

Former Democratic candidate Bernie Sanders was even more direct. In a tweet posted Wednesday, he linked to the Huffington Post report, saying “This is what corporate control of our government looks like.”

Aetna denies allegations that its exit from the exchanges was a direct response to the DOJ lawsuit, but rather a decision based on financial information obtained after the letter was sent.
“That deterioration, and not the DOJ challenge to our Humana transaction, is ultimately what drove us to announce the narrowing of our public exchange presence for the 2017 plan year,” an Aetna spokesperson said.


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