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Aetna just cut Walgreens from its Medicaid plan in Illinois

On January 3, Modern Healthcare reported that as of December, Aetna has dropped Walgreens—a major CVS competitor—from its Illinois Medicaid plan’s pharmacy network, impacting 400,000 members.

Ever since the CVS/Aetna deal closed in late 2018, we’ve been tracking how the merger of a major insurer with a pharmacy and healthcare services giant will impact the choices individuals with Aetna health insurance have when accessing care. Aetna’s launch of a new plan in Kansas City that pushes individuals toward CVS’ services, MinuteClinics, and HealthHUBs grabbed our attention last month (this story covered in more detail here) and now we’re seeing more of the same anti-competitive behavior: Effective December 1st, 2020, Aetna has dropped Walgreens—a major CVS competitor—from its Illinois Medicaid plan’s pharmacy network, impacting 400,000 residents across the state.

Chicago news outlets are reporting that poor, majority-Black Chicagoans living on the South and West sides of the city, people who have been disproportionately affected by COVID-19 and unemployment, could find it hardest to get their prescriptions filled as a result—whether it’s because they now have to commute further to an in-network pharmacy, or because this forces increased reliance on independent pharmacies with shorter hours and smaller supplies of medications. Amidst growing concern that certain low-income neighborhoods in Chicago are becoming pharmacy deserts, Aetna’s exclusion of Walgreens is being met with criticism from doctors and local lawmakers alike.

Aetna, however, is defending its decision, claiming that its network does not create access problems and meets all the state’s requirements for managed care organizations. Our take? This is just another example of how vertical integration in the health insurance industry can lead to restricted choice and access to care for patients when they need it most.

Original Article:

In a written statement, Aetna, which owns Walgreens' rival CVS, responded it has nearly 2,000 in-network pharmacies statewide for Medicaid members, including independent pharmacies and those in national and regional chains such as Walmart and Jewel-Osco.

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