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Aetna will not reenter ACA markets, still debating appeal for merger block

CEO Mark Bertolini indicated Aetna is still weighing whether to appeal court ruling blocking merger with Humana.

Susan Morse, Managing Editor

Aetna will not expand its current Affordable Care Act market this year or next, CEO Mark Bertolini said during a recent video interview by Bloomberg.

ACA product losses totaled $450 million in 2016, according to Aetna's earnings report released this week. This represents less than 4 percent of the company's revenue, according to Bertolini.

Insurers must file premium rates by April 1, and there's not enough information on what's happening in the ACA markets to get into the ones the insurer left last year, he said. It would be 2019 before Aetna could implement a program, he said.

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Last year, Aetna withdrew from the Affordable Care Act market in 17 counties in Florida, Georgia and Missouri, saying it was a business decision over financial losses. However, the judge who ruled against Aetna's $37 billion merger with Humana, said discovery documents revealed in court showed the withdrawal was an attempt by Aetna to lessen federal antitrust concerns.

[Also: Aetna faces class action lawsuit over Obamacare exits]

The insurer now operates on the exchange market in four states. Last year it operated in 15 states.

Open enrollment in the ACA ended January 31, with Republicans ready to repeal and replace Obamacare, though currently without a consensus on a replacement plan.

Bertolini indicated that Aetna is still weighing whether to appeal the January decision by the federal court blocking the proposed merger with Humana.

[Also: Court blocks Aetna, Humana merger]

"We have until Feb. 15 to figure that out," Bertolini said during the Bloomberg interview, a reference to Aetna's merger contract deadline.

If no deal is made by then, Aetna will owe Humana a $1 billion breakup fee.

"Aetna, Humana, we can't keep going on for a long time," Bertolini said on Bloomberg. "We've been doing this together for 19 months, we need to come to a conclusion relatively soon."

During the interview, Bertolini also addressed President Donald Trump's executive order on a travel ban for people coming into the United States from seven majority Muslim countries.

Bertolini said he is the grandson of an immigrant. The company has employees in the Middle East, he said, and Aetna will make sure they're treated fairly. 

This week Aetna reported 2016 net profit of $2.27 billion, compared to $2.39 billion in 2015, and operating profit of $2.9 billion compared to $2.7 billion in 2015. Much of the difference between its net and operating profit is attributed to money spent in restructuring attributable to its attempt to acquire Humana.

The increase in total revenue and operating revenue during fourth-quarter and full-year 2016 was primarily due to higher premiums in Aetna's healthcare segment, the company said.

For the fourth quarter, Aetna reported profit of $139 million, compared to $321 million for the last three months of 2015, and operating earnings of $578 million compared to $482 million in 2015, according to the earnings statement.

Twitter: @SusanJMorse