Partner Interview
Published October 3, 2025
Elevance Health and ACA Marketplace Dynamics
inpractise.com/articles/elevance-health-aca-marketplace
Executive Bio
Former Director at Aetna
Summary
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Interview Transcript
Disclaimer: This interview is for informational purposes only and should not be relied upon as a basis for investment decisions. In Practise is an independent publisher and all opinions expressed by guests are solely their own opinions and do not reflect the opinion of In Practise.
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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.to 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.
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