As recently as April 2016, Aetna CEO Mark Bertolini sounded quite positive about the insurer's participation in exchange marketplaces, describing them as a "
good investment" in a call with investors. A month later, he again said Aetna planned to participate in the Affordable Care Act's exchanges.In August, however, everything changed. Aetna, one of the nation's largest private insurers, surprised many by
announcing that it was losing money through "Obamacare" plans and would therefore scale back its role considerably.Republicans, naturally, pounced on the news, pointing to Aetna's announcement as powerful evidence of a failing ACA. As we
discussed at the time, there was a lingering question about whether the insurance company was telling the whole story: the Obama administration was standing in the way of Aetna's proposed merger with Humana, which didn't make Aetna at all happy.Was it possible the insurer was getting some election-year payback? Or was this some kind of leverage play, in which Aetna would participate more broadly if the administration played ball with the company's merger plans, using the exchanges as a bargaining chip?Plenty of people thought this was conspiratorial thinking. It now appears
they were mistaken.
America's second-largest health insurance company stopped offering coverage to hundreds of thousands of people as part of a legal strategy to avoid government scrutiny of a planned merger, a federal judge said in a ruling today. [...]The health insurance giant said it exited the exchanges purely for business reasons, having lost a total of $420 million due to plans sold through the marketplaces. But in a ruling blocking its merger with Humana today, DC District Court judge John Bates said it was also done as a legal maneuver.
Republicans who used this as a talking point last year should probably take a moment to realize they fell for a bogus claim.The
L.A. Times' Michael Hiltzik's
piece is also well worth your time.
Aetna executives had moved heaven and earth to conceal their decision-making process from the court, in part by discussing the matter on the phone rather than in emails, and by shielding what did get put in writing with the cloak of attorney-client privilege, a practice Bates found came close to "malfeasance."The judge's conclusions about Aetna's real reasons for pulling out of Obamacare -- as opposed to the rationalization the company made in public -- are crucial for the debate over the fate of the Affordable Care Act. That's because the company's withdrawal has been exploited by Republicans to justify repealing the act. Just last week, House Speaker Paul Ryan (R-Wisc.) cited Aetna's action on the "Charlie Rose" show, saying that it proved how shaky the exchanges were.
I'll look forward to GOP leaders walking back their claims, which I'm sure they'll be eager to do. Any minute now.
