Elevance Health and ACA Marketplace Dynamics
Former Director at Aetna
inpractise.com/articles/elevance-health-aca-marketplace
Elevance Health and ACA Marketplace Dynamics(October 3, 2025)
Former Director at Aetna
Interview Transcript
This is a snippet of the transcript.Contact Salesto get full access.
Let's change topics a bit. I want to ask you about Aetna and then Anthem. You mentioned Aetna exited the ACA business, and I believe you predicted that. Can you explain what went wrong there?
Within a couple of years, they entered about 15 to 17 markets. In Texas and Florida, they experienced a significant influx of business because Bright Health exited those states. This resulted in about 2.5 million people needing new coverage, and Aetna appeared to be a good option. However, this influx was overwhelming because they weren't prepared administratively and hadn't developed an effective pricing strategy, which can be devastating.
This is a snippet of the transcript.Contact Salesto get full access.
Let's change topics a bit. I want to ask you about Aetna and then Anthem. You mentioned Aetna exited the ACA business, and I believe you predicted that. Can you explain what went wrong there?
Resources were diverted to support those two states, leaving California's needs unmet. For instance, exchange contracts require sending ID cards within 10 days and grace period notices in a specific cadence. California dictates the type, size of font, and verbiage for these notices. Aetna attempted to use the same notices nationwide, which was not permissible under the contract.
This is a snippet of the transcript.Contact Salesto get full access.
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