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In a blow to President Obama’s health care law, Aetna, one of the nation’s major insurers, said Monday that it would sharply reduce its participation in the law’s public marketplaces next year. Aetna said it would no longer offer individual insurance products on the exchanges in about two-thirds of the 778 counties where it now provides such coverage. The company will maintain a presence on exchanges in Delaware, Iowa, Nebraska and Virginia, it said. (Pear, 8/16)

Aetna Inc, the No. 3 U.S. health insurer, on Monday said that due to persistent financial losses on Obamacare plans, it will sell individual insurance on the government-run online marketplaces in only four states next year, down from the current 15 states. Aetna's decision follows similar moves from UnitedHealth Group Inc. and Humana Inc., which have cited similar concerns about financial losses on these exchanges created under President Barack Obama's national healthcare reform law. (Humer, 8/15)

Aetna cited unsustainable losses as the primary reason for trimming its Obamacare participation. The number of counties where it sells exchange plans will drop from 778 to 242. “Providing affordable, high-quality health care options to consumers is not possible without a balanced risk pool,” Aetna CEO Mark Bertolini said in a statement. “Fifty-five percent of our individual on-exchange membership is new in 2016, and in the second quarter we saw individuals in need of high-cost care represent an even larger share of our on-exchange population.” (Demko, 8/15)

Aetna’s move will sharpen concerns about competitive options in the exchanges—and it puts at least one county, Pinal in Arizona, at risk of having no insurers offering exchange plans in 2017, a circumstance that would present a major challenge to the basic mechanics of the ACA. ... Stephen Briggs, a spokesman for Arizona’s state insurance regulator, said the state currently has no insurers that have filed to offer exchange plans in Pinal, a county in the Phoenix area.“It’s a concern for us,” he said, but the regulator doesn’t “have any legal leverage to compel anyone to offer a plan.” (Wilde Mathews, 8/15)

Next year will be the law’s fourth of providing coverage under the new markets. Aetna’s decision doesn’t affect people covered by the company this year, but when they look for 2017 coverage, they’ll need to pick a new insurer. The decision raises the prospect that some consumers will only have one insurer to choose from when they buy 2017 coverage. (Tracer, 8/15)

Aetna, which had 838,000 exchange customers at the end of June, said its policyholders are turning out to be sicker and costlier than expected. The company, along with its peers, has criticized the federal program designed to mitigate those risks. (Luhby, 8/15)

The Obama administration argued the move is not a sign that the ObamaCare marketplaces are in trouble. “Aetna’s decision to alter its Marketplace participation does not change the fundamental fact that the Health Insurance Marketplace will continue to bring quality coverage to millions of Americans next year and every year after that,” said the administration’s ObamaCare marketplace CEO, Kevin Counihan. (Sullivan, 8/15)

Aetna's announcement comes as the insurer is locked in a battle with the U.S. Department of Justice over its effort to acquire Humana for $37 billion. The department sued to block the deal and a trial is scheduled to begin Dec. 5. (Singer, 8/15)