Now that the third largest insurer in the country is pulling out of Illinois public healthcare exchange, what happens to the hundreds of thousands of participants?

Aetna announced last week that it was pulling out of 11 of 15 of the state health exchanges they participate in, including Illinois.  This is announcement comes shortly after United Healthcare announced it will no longer participate in the exchanges and Land of Lincoln Health announcing bankruptcy after suing the federal government for hundreds of millions it was owed.

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According to the Illinois Department of Insurance, there are over 1 million insured participants in the state, but only about 400 thousand participate in the exchange program. The rest receive Medicaid benefits.

Mercatus senior research fellow Brian Blase says those numbers are troubling for the future success of the program. "Healthy participants are saying 'I'm not going to pay seven or eight thousand dollars in healthcare costs this year, so there's no way I'm going to purchase that coverage,'" he said. "The exchange is probably way below what they thought enrollment would be."

He says the lack of healthy participants are forcing tough choices for Illinois' high-cost exchange participants. "I think you have to put sicker people into some kind of state high-risk pool," he said.

Aetna insured over 830 thousand people through state exchanges as of June. The Connecticut-based company expects to lose $300 million on the plans.

(Copyright WBGZ /