Aetna CEO Mark Bertolini
Photo: Andrew Harrer/Bloomberg/Getty
By Sy Mukherjee
February 15, 2017

Mark Bertolini, CEO of health insurance titan Aetna (aet), isn’t holding back when it comes to Obamacare.

Bertolini said that he believes Obamacare is in a “death spiral” at a Wall Street Journal event, according to Politico. “It’s not going to get any better, it’s getting worse,” he said, adding that he believes even more insurance companies will pull out of the health law’s marketplaces in the near future.

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Bertolini’s comments come amid a moment of reckoning for Obamacare. The law was already facing an onslaught of negative publicity last year as massive insurers like UnitedHealth (unh) retrenched from participating in its marketplaces and other firms spiked premiums thanks to enrollees’ unexpectedly high medical costs.

And now that Donald Trump and a GOP Congress hostile to the law control the levers of power in Washington, some other insurers are feeling free to follow suit. On Tuesday, Humana (hum) (whose planed merger with Aetna was just scuttled) announced further withdrawals from Obamacare.

Aetna had already significantly scaled back its Obamacare participation last year, citing unsustainable financial losses. But some analysts note that the high-profile departures don’t necessarily reflect the overall health of Obamacare’s marketplaces since other companies like Blue Cross Blue Shield dominate the space.

Bertolini, for his part, also offered up some thoughts on a potential replacement for Obamacare on Wednesday. “The repeal is easy. They can do that tomorrow if they want to. The question is what does the replacement look like and how long does it take to get there,” he said, endorsing measures such as a reinsurance fund to stabilize Obamacare’s marketplaces.

The Trump administration on Wednesday issued a number of rules tweaking the health law as a potential replacement strategy takes hold, including loosening the penalties imposed on Americans who can’t prove they’ve purchased health insurance.

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