The health insurance giant Aetna told investors it plans to stop offering plans nationwide on the Affordable Care Act marketplace exchange next year. The ACA is also known as Obamacare and, in Georgia, is run by the state as Georgia Access.
The move comes amid rising uncertainty about federal support for the marketplace in 2026. Immediately, it means 107,000 Georgians on the marketplace who currently hold Aetna policies will have to choose another carrier this fall, if they sign up for 2026 coverage.
Monty Veazey, a lobbyist who represents the state’s community hospitals, including many in rural Georgia, wasn’t happy to hear the news.
“It’s going to put a lot more stress on (people in rural areas) in finding affordable health care,” Veazey said. “We can only do so much.”
Aetna’s decision is not a blockbuster in itself. Aetna insures a relatively minor fraction of the state’s 1.5 million Georgia Access policyholders. And the exchange now has so many companies offering plans throughout Georgia’s 159 counties that none will be left bare by the exit of just one insurer, said state Office of Insurance and Safety Fire spokesperson Bryce Rawson.
Instead, the news sent analysts wondering if it’s a harbinger of worse to come for the ACA marketplace overall. That’s because of a big unsettled decision awaiting Congress right now regarding support for the ACA exchange past Dec. 31.
Ever since the pandemic, the federal government has been spending more money to offer an increased number of people affordable ACA plans. It worked, and sign-ups have soared nationwide. But that extra help, called “enhanced” subsidies, is scheduled to scale back at the end of the year. Subsidies would return to their original prepandemic levels.
The people helped by the enhanced subsidies include those who earn more than 400% of the federal poverty level — which works out to $62,600 for an individual living alone, or $128,600 for a family of four.
In those cases, the ACA before enhanced subsidies did not offer any help, and those consumers on the exchange had to pay full market price of the insurer’s premium. Others helped included those barely at the poverty level, whose plans became virtually free.
After enhanced subsidies went into effect, Georgia’s exchange had one of the biggest expansions in the nation, more than doubling.
Advocates want Congress to extend the enhanced subsidies. But GOP leaders in Congress and President Donald Trump are trying to cut spending, not increase it. The estimated cost of extending the enhanced subsidies would be $335 billion over 10 years, according to the Congressional Budget Office.
Analysts have said hundreds of thousands of Georgians are likely to find ACA policies unaffordable and will drop them without the subsidies. About 300,000 Georgians will be unable to find other insurance that works for them and will simply go uninsured, according to analysts.
However, some are skeptical that Aetna’s pullback is some kind of bad signal. They point out that Aetna has long been a modest player in the market, if it was there at all. And recently, it’s been losing money on the exchange, according to CVS Health executives’ statements to investors.
In a written statement to The Atlanta Journal-Constitution, a spokesperson for CVS Health, which owns Aetna, said the move makes financial sense for the company.
“We are proud of the work we have done in the Exchanges since 2022, especially in what has been a fast-changing health care landscape,” the statement said.
Rawson, the state Office of Insurance spokesperson, said Georgia can handle whatever Congress decides to do with the enhanced subsidies.
“We’re going to keep monitoring what’s happening at the federal level,” Rawson said. “I think we’re hoping that our lawmakers — our senators, our representatives — that they will just make a decision. For or against. We will react accordingly.”
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