Aetna, a healthcare insurance provider, plans to stop offering plans through the Affordable Care Act Marketplace in 2026. Approximately 10,000 residents in Ohio will need to find new insurance starting in the New Year.
This withdrawal affects around one million people across the United States, occurring amid instability in the healthcare sector. One notable concern is the potential expiration of ACA subsidies at the year’s end, unless Congress and President Trump decide to extend them, which could lead to higher costs for consumers in the ACA market.
An Aetna spokesperson stated via email that the decision was influenced by “significant regulatory uncertainty” and various economic factors.
Aetna, which is owned by CVS, emphasized that the Aetna CVS Health Plans were intended to provide maximum value for its members. However, they acknowledged that it is becoming increasingly difficult to maintain that same level of value, especially looking toward the future. They aim to assist their members in optimizing their benefits during 2025.
What about the subsidies?
The enhanced ACA subsidies, initiated under the American Rescue Plan Act in 2021, are projected to expire at the end of 2025. These subsidies have expanded existing tax credits, increasing premium support for low-income individuals, which has made healthcare more affordable. They even provide support for incomes reaching up to 400% of the federal poverty level, or from $62,600 to $128,600 for a family of four.
Without these subsidies, a KFF Health News Analysis indicated that average health insurance premiums for ACA enrollees are set to rise by 93% in 2024. In Ohio, this could mean an increase between 50% and 100%.
The Congressional Budget Office (CBO) estimates that roughly 3.8 million more people could be uninsured annually due to rising premiums.
What options are there for Aetna Marketplace plan users?
Aetna’s exit from the market is scheduled for December 31, 2025. If you currently hold an Aetna ACA Marketplace plan, there will be no immediate coverage reductions. Most new enrollment periods will follow the standard open enrollment timeline on Healthcare.gov.
For a list of available plans in Ohio, you can consult the Ohio Department of Insurance website.
