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A Judge Just Ruled Aetna Lied About Why They Quit Obamacare

A Judge Just Ruled Aetna Lied About Why They Quit Obamacare

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A federal appeals court judge in Washington, D.C. just ruled that health insurance giant Aetna made a political move to pull out of Obamacare for reasons entirely to do with politics and not to do with philosophy or profits. The insurer contributed to the rise in insurance premiums for Obamacare exchange participants, which impacted self-employed Americans across the country, just so it could seek a better deal in its proposed $37 billion dollar merger with Humana.

The judge’s ruling (starting on page 125 in the document below) is not just an opinion but is factually based upon the internal communications discovered in the course of the Department of Justice’s litigation:

During the investigation but before the complaint was filed, Aetna tried to leverage its participation in the exchanges for favorable treatment from DOJ regarding the proposed merger.

Aetna and its CEO, Mark Bertolini, have long been supporters of the public exchanges. Bertolini believes that “every American should be insured,” and that doing so through the exchanges is a good business opportunity. He has consistently expressed a desire for Aetna to “have a seat at the table” and to help ensure everyone is covered.

On May 11, 2016, Bertolini was deposed in DOJ’s investigation. At that deposition, Aetna’s counsel stated that if Aetna was not “happy” with the results of an upcoming meeting regarding the merger, “we’re just going to pull out of all the exchanges.”

What’s even worse, is that Aetna’s executives knew that their motives were impure and would lead to serious harm for their current policy-holders and to the broader insurance exchanges, so they took an extraordinary step. Aetna’s executives specifically ordered steps be taken to avoid their communications from being discovered in court, and the main culprit was their Head of Exchanges, Johnathan Mayhew, as the judge noted:

In response, Mayhew began what would become a series of emails where Aetna executives tried to conceal from discovery in this litigation the reasoning behind their recommendation to withdraw from the 17 complaint counties. Mayhew explained: “I was told to be careful about putting any of that in writing. I will have the attorney client privilege ccd by tomorrow.”

He agreed that the purpose of shielding these documents was to conceal how Aetna was handling the decisions about its exchange footprint. Mayhew acknowledged Aetna executives instructed each other to call, rather than email, to avoid creating a written trail that could be revealed in discovery.

Republicans held up Aetna as proof that the Obamacare insurance markets didn’t work, but the reality is that they work just fine unless a company wants to make a very public, political play to obtain a merger that will erase competition from the market, thereby raising the price of private services. It’s the very reason why former Democratic presidential nominee Hillary Clinton went to bat for every American in the early 1990s and paid the price of picking up powerful enemies that would dog her career to this day.

Aetna’s unconscionable decision-making in the pursuit of a profitable merger lays bare the conflicts of interest which every private health insurer cannot shake in pursuit of profit while operating their private businesses, which has never been shown to provide any noticeable benefit over public health insurance plans.

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Here’s the proof that Aetna raised your health insurance premiums and lied to the American people. The details are on page 125:

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Aetna Ruling by Grant Stern on Scribd

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