Earns Aetna

In this Tuesday, Aug. 19, 2014, file photo, a pedestrian walks past a sign for health insurer Aetna Inc., at the company headquarters in Hartford, Conn. Aetna Inc. reports financial results Tuesday, Aug. 2, 2016.

(AP Photo/Jessica Hill)

Aetna, one of the United States' largest health insurance companies, announced it would drastically reduce its participation in the Affordable Care Act to marketplaces in four states.

The company will stop offering individual plans in about two-thirds of the currently covered counties in 2017, reducing its footprint to 242 counties next year, according to a press release issued Monday.

Aetna will only only offer plans on public exchanges in Delaware, Iowa, Nebraska and Virginia to limit future financial losses.

The company reported a $200 million pretax loss in the second quarter, which included losses from outside the Affordable Care Act marketplace plans. It said it has lost $430 million since January 2014 on individual plans.

"Providing affordable, high-quality health care options to consumers is not possible without a balanced risk pool," Mark T. Bertolini, the chairman and chief executive of Aetna, said in a statement.

Bertolini said that "individuals in need of high-cost care represent" a disproportionate amount of Aetna enrollees in the marketplace and the federal government has failed to adjust payments to cover these costs.

The company remains "hopeful" that it can work with lawmakers to establish a sustainable marketplace, he said.

"It's no surprise that companies are adapting at different rates to a market where they compete for business on cost and quality rather than by denying coverage to people with preexisting conditions," Kevin Counihan, Marketplace CEO, said in a statement in response to Aetna's announcement. "With high consumer satisfaction, more people getting care, and an improving risk pool, incoming data continue to show that the future of the Marketplace is strong."

The health insurance company pulled out of the New Jersey exchange just weeks before residents began to enroll in 2013.

The announcement does not affect 2016 plans, the company said. Current enrollees will receive transition resources during the 2017 open enrollment period.

"We are committed to a health care marketplace that gives every American the opportunity to access affordable, high-quality care," the company said. "We will continue to evaluate our participation in individual public exchanges while gaining additional insight from the counties where we will maintain our presence, and may expand our footprint in the future should there be meaningful exchange-related policy improvements."

Aetna said last week it has been swamped with higher than expected costs, particularly from pricey specialty drugs, and it will take a hard look at its current presence on exchanges in 15 states. When asked by The Associated Press whether that meant the insurer might leave the exchanges entirely or just some markets in 2017, CEO Mark Bertolini said: "All of the above."

Major insurers like UnitedHealth Group Inc. and Humana Inc. have already said they are scaling back their exchange participation in 2017, and several smaller, nonprofit insurance cooperatives are winding down business after losing millions.

Blue Cross-Blue Shield insurer Anthem Inc. recently reported a surprising loss from its exchange business.

The Associated Press contributed to this report.

Craig McCarthy may be reached at CMcCarthy@njadvancemedia.com. Follow him on Twitter @createcraig. Find NJ.com on Facebook.