Aetna versus the states

Will Calif. and other states step in like Massachussets has done? Will a Democratic president and congress cover folks under 65 within a few years? Will the insurance companies oppose all these moves or try to pre-empt them, in a public-private partnership? I keep looking for signs.

Here's a quote from a newsletter Aetna just sent to its agents--

"Since California failed to adopt its comprehensive health reform package, more eyes may now turn to Massachusetts to learn more about the ins and outs of comprehensive health care reform. Health Reform Weekly has reported in recent weeks that costs for the Massachusetts plan are rising well beyond anyone's expectations (see below), making it likely that taxpayers will have to bear hundreds of millions of dollars in extra costs or the state will have to scale back its plans.
However, a study released last week by the Massachusetts Hospital Association did provide some good news — the number of "free care" visits to hospital emergency rooms declined by 28 percent over the past three years as uninsured people have enrolled in subsidized health care plans. This, of course, is what was supposed to happen, but the study offers the first real evidence that the Massachusetts approach is working in this important regard. Having more people covered in subsidized plans should mean more efficient delivery of health care and better quality for patients."

SO, Aetna sends a mixed message: first, the Massachussets program will hit taxpayers hard; second, the law is succeeding by improving health outcomes. People there are required to sign up for health insurance, just as they are for car insurance. So Aetna is still in business, even though they are kind of competing with a state-sponsored plan.
The good news for Aetna is that the state's program is mostly geared for low-income folks who were not customers of Aetna anyway. In the long run, though, the state-run program may get big enough to be real competition.