CVS Health’s subsidiary Aetna will exit individual markets by 2026, marking less than five years after its return to this space. The move is aimed at improving business performance.
Aetna operates about 1 million members in exchange plans and will withdraw from the Affordable Care Act’s exchanges where it independently offers plans. CVS CEO David Joyner stated that Aetna determined there was no short- or long-term strategy for improvement.
The decision comes after a mixed history with the exchanges, including a previous exit in 2018 due to massive losses. However, in 2021, Aetna aimed to re-enter the market, but struggled with lower-than-expected enrollment numbers.
CVS Health’s overall performance has been affected by rising utilization costs and headwinds faced by peers. The company reported a medical loss ratio of 87.3% for the first quarter, down from 90.4% in the previous year.
Despite this, CVS still delivered strong earnings, with $1.8 billion in profit and $94.6 billion in revenue, surpassing Wall Street’s estimates. Revenues at its pharmacy benefit management unit increased by 7.9%, driven by growth in specialty pharmacy, drug mix, and inflation on branded products.
Source: https://www.fiercehealthcare.com/payers/aetna-exit-aca-exchanges-2026