With mere months to go in the twilight of his presidency, Barack Obama has spent the lame duck portion of his term burnishing his legacy.
But the Affordable Care Act, better known as Obamacare, might detract from that sheen as healthcare insurers are abandoning the program en masse. Aetna, the managed healthcare giant, announced it will join more than 40 other insurers in abandoning Obamacare.
Aetna said it will no longer sell Obamacare in 11 of the 15 states where it previously offered the plan after losing $430 million in the first half of 2016, according to NPR. Aetna's announcement comes on the heels of major insurers Humana and UnitedHealth Group also significantly scaling back participation in Obamacare.
"The way the law's complicated structure worked is that insurers needed an adequate number of those enrollees to be young and healthy to offset losses that insurers would face on older and sicker enrollees," said Brian Blase, a research fellow at Georgetown's Mercatus Center, CNBC reports. "And it turns out that the coverage available through the exchanges is really only attractive to people who either receive large subsidies to purchase the coverage, or who are relatively sick and expect to incur large medical expenses."
Asked about the fines -- which are levied against people who don't have health insurance and don't purchase Obamacare -- Blase told a CNBC host that people are choosing to pay a fine instead of purchasing the healthcare because the plans are prohibitively expensive.
"The fines incentivize some people to purchase the coverage, but the fines are relatively small compared to the price of the premiums and the large deductables that we're seeing per exchange plans," Blase said. "We're seeing most individuals are making the economically rational choice not to purchase the coverage because the coverage isn't worth it."
As more healthcare insurers pull out of the Obamacare market, Democratic and Republican lawmakers might agree to modify the law, Kaiser Family Foundation Vice President Larry Levitt told CNBC.
"It seems increasingly apparent that the big, national insurers are having trouble making money and competing in the ACA marketplaces," said Levitt. "Some insurers, particularly those that historically served the Medicaid market, are doing better. It's clear that there's going to be less competition and choice in the marketplaces in 2017."
If enrollment in Obamacare dips in 2017, Levitt said, "it will likely precipitate a debate about how to fix the law, amidst big disagreement among Democrats and Republicans about what those fixes look like."
Federal officials say the healthcare companies and insurers are to blame, per NPR.
"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," Kevin Counihan, CEO of HealthCare.gov, told NPR.