Clock Ticking on Whether Aetna, Anthem Will Join Obamacare Exodus

The fate of Barack Obama’s signature health-care law may depend on how long Anthem Inc. and Aetna Inc. are willing to wait before starting to make money off it.

The two insurers are on the hot seat now that UnitedHealth Group Inc. appears unlikely to linger as a seller on the Affordable Care Act’s government-run markets. UnitedHealth, the U.S.’s largest health insurer, said Thursday that if it can’t turn a profit, in 2017 it may quit the health plan marketplaces where millions of Americans buy coverage.

While UnitedHealth has a small share of that market, Anthem and Aetna are two of the biggest players. Like UnitedHealth, neither has had financial success there — Aetna has said it’s losing money, while Anthem is making less than it would like. They’re both working to widen profit margins and have said their strategy is based on the expectation that covering people under the law will become more profitable.

“It looks like it’s more of a United issue, with some flavoring of national issues,” Bill Melville, an analyst who focuses on health insurance exchanges at Decision Resources Group, said by phone. “It’s a wake-up call that there’s been some pretty rough headwinds.”