Bloomberg Business

Aetna Inc., facing more than $300 million in losses from Affordable Care Act health plans this year, may exit Obamacare markets in some states as challenges to the health-care overhaul pile up.

While the health insurer has yet to leave any states in which it now sells Obamacare programs, Chief Executive Officer Mark Bertolini said Aetna is evaluating its participation by market and will start making decisions in coming weeks. The company, which covers 838,000 people through Obamacare, is halting a planned expansion of those offerings in new states for next year.

“We’ve got to be able to cover the costs associated with providing the care,” Bertolini said in an interview.

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Anthem Inc., the No. 2 U.S. health insurer by membership, said medical spending rose in the second quarter, driven by higher costs from the insurer’s Affordable Care Act plans and Medicaid business.

The shares dropped as much as 4.1 percent, the biggest intraday decline since April 27, and were down 0.5 percent to $136.95 at 9:55 a.m. Anthem said it spent 84.2 cents of every premium dollar on medical care, up from 82.1 cents a year earlier.

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UnitedHealth Group Inc. will pull out of Kentucky’s individual marketplace for ObamaCare plans, bringing to 26 the number of states the health insurer is quitting next year.

The company plans to halt sales of individual plans in Kentucky for 2017, both inside and outside the state’s Affordable Care Act exchange, as well as the small-business exchange, UnitedHealth said in a letter to the state’s insurance department. The letter was obtained by Bloomberg through an open records request.

UnitedHealth’s exits from the state ObamaCare markets threatens to limit the number of options for consumers when they shop for coverage for next year.

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The head of the third-biggest U.S. health insurer said he has “serious concerns” about whether or not ObamaCare’s new markets are sustainable, echoing criticism from other top for-profit insurers.

“We continue to have serious concerns about the sustainability of the public exchanges,” Aetna Inc. Chief Executive Officer Mark Bertolini said on a call Monday while discussing the company’s fourth-quarter results. “We remain concerned about the overall stability of the risk pool.”

Large U.S. health insurers have faced a rocky start in the Patient Protection and Affordable Care Act, which in 2014 opened up new markets where millions of Americans buy coverage, often with tax subsidies to help them afford it. Aetna is one of the biggest insurers in ObamaCare and, like its rivals UnitedHealth Group Inc. and Anthem Inc., has struggled to make a profit in the business.

Anthem Inc., the second-largest U.S. health insurer by membership, said premiums for ObamaCare insurance probably will go up next year.

Anthem is eking out a small profit from selling policies to individuals under the Affordable Care Act. Many of its rivals aren’t, though, which means prices have to go up, the company told investors and analysts on Wednesday.

Other insurers are charging premiums that are “still well below what we think appropriate rates are for a sustainable environment,” Chief Financial Officer Wayne DeVeydt said on a conference call with analysts.

The U.S. government will limit a process that allowed people to sign up for health insurance under ObamaCare outside of the normal enrollment period. Typically, individuals have from about November to January to purchase insurance under ObamaCare. In some cases, though, they’re allowed to sign up outside that period, such as when they have a child.

The government is also tightening an exception that let people sign-up when they moved, by clarifying that people can’t get coverage based on a short-term or temporary relocation, the Centers for Medicare and Medicaid Services said in a blog post on Tuesday. It also plans to more tightly enforce other limits on enrollment by making sure people are qualified to sign-up in the remaining special circumstances.

UnitedHealth Group Inc., the largest U.S. health insurer, said its rates for ObamaCare plans in New York may be too low because the failure of a competing insurer last year might lead to shortfalls in payments designed to stabilize Obamacare markets.

In states like New York, health insurers participating in ObamaCare negotiate annually with regulators to set prices for coverage. UnitedHealth’s rates were set anticipating risk-sharing payments designed to stabilize the new insurance markets, William Golden, the company’s northeast region chief executive officer, said Wednesday. If the loss of a participant reduces the funds available to UnitedHealth, the company’s rates in New York’s ObamaCare market may be insufficient, he said.

The U.S. Treasury and Internal Revenue Service said they are extending some Affordable Care Act reporting deadlines to help companies meet the requirements. Employers will have two more months past Feb. 1 to give individuals forms for reporting on offers of health coverage and the coverage provided.

he deadlines to report this information to the IRS are extended by three months past the previous Feb. 29 due date for paper filings and the March 31 date for electronic returns, the Treasury said in a statement Monday.

Jeb Bush has lately been defending his brother George — the former president — against Donald Trump’s criticism, and George is raising funds for Jeb’s presidential campaign. What all this fraternal support obscures is the extent of the policy differences between the two. Despite his reputation for moderation, on issue after issue Jeb has taken positions that are significantly to the right of his brother’s — and of every other president in recent memory.