An open letter to the Aetna CEO

Dear Mark T. Bertolini, Chairman and CEO, Aetna,

As a former actuary, benefits consultant, benefits manager, and a business and personal client of Aetna, I recognize fully the complexity of healthcare delivery and insurance in the US. I understand the meaning of claims loss ratios and the need for Aetna to earn a profit for its shareholders.

With this context, I ask that you please reconsider pulling Aetna out of the Healthcare exchanges in North Carolina and other states. I became an Aetna customer again when Aetna purchased the business of Coventry and integrated the two companies into the Aetna network. On the whole, our service has been good and we appreciate your negotiated discounts with Carolinas Medical Center and its doctor network. Many insureds do not realize the value of these discounts that must be paid by uninsureds.

The Affordable Care Act is still in its early childhood, but it has accomplished increasing coverage to over 20 million people. It has dampened healthcare cost increases, but tools to aid insurers like Aetna with initial years adverse selection, have been strangled by Congress whose majority wants to see the law fail. This added funding, called risk corridors, would have tied Aetna and other insurers over until the adverse selection (people initially overusing the healthcare due to pent up demand) stabilized. This plus the refusal of our state to expand Medicaid and the naysaying of the law, also led to a poorer risk pool than you anticipated.

I recognize Aetna must make money, but the ACA is actually working pretty well in spite of these challenges. And, as an actuary, I know the cost of healthcare is going up in America irrespective of the plan due to our aging society and being the most obese country in the world. We are train wrecks waiting to happen, so the ACA will get folks to see the doctor sooner rather than later which will ameliorate future increases.

Please reconsider your position and bear with us. We need competition in our state and BCBS will be the only insurer left. Also please aggressively discuss with our State Insurance Commissioner about needed increases and our Congress about funding the risk corridors. This will help assure its success. To be frank, if the ACA went away, over 20 million Americans would suffer and we would likely enter a recession with less spending in our economies. Aetna is too good a company and there is a greater good in staying with us. Thank you for considering my request.