n 2004, Bertolini himself came close to death after breaking his neck in a skiing accident, leaving him with some permanent injuries. He readily admits that his health problems likely would mean he'd be rejected for coverage if he were to seek a policy on the individual market today.
After 2014, however, insurers such as Aetna will no longer be able to reject applicants for medical reasons under the health care law approved by Congress last year. That year, most Americans also will be required to buy coverage, a policy called the "individual mandate."
Bertolini joined Aetna in 2003 and he became chief executive and president in November. He's also held executive positions at Cigna, NYLCare Health Plans, and SelectCare. Here are edited excerpts of a recent conversation:
Q: Can the health law work without the individual mandate?A: In 2005, we were considered crazy because we came out and said we thought the individual mandate is essential to the health care system. We were the first company to say that. It's about how insurance market pools work. We don't think that in the individual mandate in the Affordable Care Act is strong enough. (Because the penalty for not having coverage isn't high enough.) It's pretty likely it won't survive the constitutional challenge. (Lower courts have split on the issue, which is likely headed to the Supreme Court). Then we will have a whole different ballgame.
Believe me, there isn't anyone in Congress or the White House who thinks (the law) can stand without the individual mandate. They would have to tackle the risk issue (people waiting to buy insurance until they fall ill).
