Judge Rules Aetna Lied About Reason for Leaving Obamacare Exchanges

In reality Aetna knew that Obamacare was going to be profitable. But they lied on why they withdrew. I remember some on the board were gleeful when Aetna announced they were pulling out. There seems to be no honesty left at the top levels of management in American Corporations.
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This is a really critical story on a number of levels. The debate over Obamacare has been shaped to a great extent over the last year by Aetna's decision to withdraw from exchanges in a number of states because, it claimed, it was losing money. But in a ruling today which blocked a proposed merger between Aetna and Humana, federal Judge John D. Bates held that Aetna's claim was bogus. Rather than being a business decision based on the inability to make a profit in those states, Bates ruled that Aetna had withdrawn from Obamacare exchanges at least in part as a strategy to threaten its way out of the anti-trust case.

Bates found that this rationalization was largely untrue. In fact, he noted, Aetna pulled out of some states and counties that were actually profitable to make a point in its lawsuit defense — and then misled the public about its motivations. Bates’ analysis relies in part on a “smoking gun” letter to the Justice Department in which Chief Executive Mark Bertolini explicitly ties Aetna’s participation in Obamacare to the DOJ’s actions on the merger, which we reported in August. But it goes much further.

Among the locations where Aetna withdrew were 17 counties in three states where the Department of Justice asserted that the merger would produce unlawfully low levels of competition. By pulling out, Aetna could say that it wasn’t competing in those counties anyway, rendering the government’s point moot: “The evidence provides persuasive support for the conclusion that Aetna withdrew from the on-exchange markets in the 17 complaint counties to improve its litigation position,” Bates wrote. “The Court does not credit the minimal efforts of Aetna executives to claim otherwise.”

Indeed, he wrote, Aetna’s decision to pull out of the exchange business in Florida was “so far outside of normal business practice” that it perplexed the company’s top executive in Florida, who was not in the decision loop.

http://talkingpointsmemo.com/edblog...-about-reason-for-leaving-obamacare-exchanges

 

The alternative facts have already been stated by Aetna when they liad as to why they were pulling out of Obamacare. Their internal documents show they know that the ACA would be profitable to them.

 

To those who danced with glee because Obamacare was blames it should make a difference. Obamacare would have been profitable to them. They did not pull out because they were loosing money from Obamacare. I expect you were one of those who condemned Obamacare when Atena pulled out.

 

Your alternative facts are wrong ... as alternative facts are.

From: https://www.healthinsurance.org/blog/2016/08/25/cry-me-a-river-aetna/

ThanksObamacare (seriously)
And get this: Aetna and the other big insurers wouldn’t be getting as much profitable business from the government if not for Obamacare. Keep in mind that most of the newly insured Americans have coverage because of the Medicaid expansion made possible by Obamacare. Aetna and many of its competitors have benefited financially from this expansion because many states contract with private insurers to manage their Medicaid programs.

And then there is Medicare. Aetna and many other insurers participate in the Medicare Advantage program, the private alternative to traditional Medicare, and they’ve figured out how to convert a lot of the billions of dollars in revenue they get from the federal government to profits. And, according to the Kaiser Family Foundation, the Medicare Advantage program has been growing leaps and bounds in recent years, thanks to all the marketing dollars the insurers spend every year to attract Medicare beneficiaries.

In 2010 – the year Obamacare became law – 24 percent of Medicare beneficiaries were enrolled in Medicare Advantage plans (11.1 million people). This year, 31 percent of the 57 million Medicare beneficiaries are enrolled in MA plans (17.1 million people).

So, thanks to Obama – and more specifically, Obamacare – Aetna and its competitors are rolling in the federal dough. But, because of the self-serving desire on the part of the for-profit companies’ executives to exceed Wall Street’s expectations every three months, they’re not willing to tolerate for another New York minute an Obamacare risk pool that, in their opinion, is crowded with too many sick people. People they never wanted to insure in the

Source: https://www.healthinsurance.org/blog/2016/08/25/cry-me-a-river-aetna/
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From: http://www.cnbc.com/2016/08/17/aetn...ear-but-will-exit-obamacare-market-there.html

Major health insurer Aetna included Pennsylvania on its list of 11 states where it will cease to sell Obamacare plans next year, despite the fact that it booked a decent profit on such plans in the Keystone State in 2015, records show.

Aetna collected more than $71 million in premiums, according to a recent rate filing request.


Before taxes, the company made $13.6 million from those plans, according to that same filing. That pre-tax profit represents the difference between the premiums it received, and what it paid out in claims — $52 million — and the $5.8 million it incurred in administrative expenses, Aetna said in its filing.