Aetna CEO: Obamacare Will Continue to Deteriorate If Nothing Happens

Medica's exit will leave Iowa's exchanges empty

Aetna chairman and CEO Mark Bertolini / Getty Images
May 8, 2017

Aetna's CEO Mark Bertolini said that if Obamacare does not get fixed and nothing happens to it, "it is going to continue to deteriorate."

Speaking at the Fortune Brainstorm Health Conference, Bertolini said the Affordable Care Act needs to be fixed since it cannot be repealed.

"We have a bill that's been passed and quite frankly the current legislature, the House can but not the Senate, cannot repeal it," Bertolini said. "I've spent enough time inside the legislative labyrinth understanding what can be done or what cannot be done under reconciliation, and we cannot repeal Obamacare, ACA, whatever you want to call it, without 60 votes in the Senate."

"What we need to do is admit that it needs to be fixed," he said. "Eight years without touching it, no piece of major social legislation has ever had that happen."

Aetna, one of the largest insurers in the United States, announced last week that it planned to exit the Obamacare exchanges in Iowa and Virginia, citing major losses.

"Looking beyond 2017, we continue to evaluate our footprint with a view towards significantly reducing our exposure to individual commercial products in 2018," said Shawn Guertin, Aetna's chief financial officer. "We have already disclosed our planned 2018 exit from one of our 2017 state-based exchanges and intend to communicate other 2018 footprint decisions when appropriate."

Bertolini mentioned that Medica, another health care insurer, notified Iowa last week that it was also pulling out of the exchanges which means there will be no one in Iowa with coverage.

The CEO was also critical of the cost of the Affordable Care Act, citing how a reinsurance pool would be a better solution for really sick individuals.

"When you talk to a lot of constituents who have $6,000 deductibles, live in the five eastern counties of Colorado where there isn't a doctor, a $6,000 deductible is not helpful," Bertolini said. "They don't want to buy that."

"The reason that the deductibles are so high is because we are socializing all of the costs at the premium level across the whole population, that doesn't work," he said. "What we need is a pool of money, a reinsurance pool, that at a certain attachment point, call it $25,000 or $35,000—somewhere in that range—this other pool pays for those costs, leaves the person in their product and takes the top all of the people who are really sick and stabilizes the basic pool."

Bertolini says this is a better way to stabilize premium increases, which is the critical aspect of making the program work.