Fate of Obamacare could depend on the financial patience of leading insurers Anthem and Aetna, which is buying Humana

The fate of the Patient Protection and Affordable Care Act may depend on how long two major insurance companies “are willing to wait before starting to make money off it,” Zachary Tracer reports for Bloomberg News.

Anthem Inc. and Aetna Inc. “are on the hot seat now that UnitedHealth Group Inc. appears likely to linger as a seller on the Affordable Care Act’s government-run markets,” Tracer writes. “UnitedHealth, the U.S.’s leading health-care insurer, said Thursday that if it can’t turn a profit, in 2017 it may quit the health-plan marketplaces,” such as Kentucky’s Kynect.

United and Aetna recently started offering policies on Kynect for the first time, United statewide and Aetna in only 10 counties. Anthem has been on the two-year-old exchange from the start. Across the nation, “Aetna has said it’s losing money while Anthem has said it’s making less than it would like,” Tracer reports.

“It looks like it’s more of a United issue,” Decision Resources Group analyst Bill Melville told Tracer. “It’s a wake-up call that there’s been some pretty tough headwinds.” Wells Fargo analyst Peter Costa “said he expects Anthem and Aetna to lose money on the exchanges next year, potentially leading them to reconsider their posture.”

Aetna, which is in the process of buying Louisville-based Humana Inc., has said it’s willing to wait a few years for improvement in the exchange business.