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Biden honors distinguished Americans; Trump back in N.Y. court

Biden expands health insurance access for DACA recipients

The grinding familiarity of the jocks-vs.-hippies proxy fight

Trump Media auditor charged by SEC with ‘massive fraud’

Google’s empire is massive. A judge will soon rule if it’s a monopoly.

What’s the best bus to New York? We tested 5 for comfort and value.

Adaptive equipment is making national parks more inclusive

You asked: Do I need a passport for my cruise?

The ‘Access Hollywood’ video cemented Trump’s air of invincibility

The New York Times, alone in its outrage over access to Biden

In a pinch, the Nationals finally find some offense

The Capitals, a team in transition, know what they want this offseason

Is Pastis as good as our food critic thought? He sent spies to find out.

Northern Gaza is in ‘full-blown famine,’ World Food Program leader says

Confident of victory over Ukraine, Russia exhibits Western war trophies

Journalism in India is under assault

Ask Amy: My boyfriend just confessed he’s almost $20,000 in debt

Miss Manners: Is it inappropriate to reach out to old girlfriends?

Carolyn Hax: Longtime friend won’t forgive being last-minute canceled for a guy

The Post endorses April McClain Delaney and Tom Royals for Maryland’s 6th District

On Press Freedom Day, little to celebrate for Hong Kong’s journalists

Young Georgians want to be part of Europe. Their government is in the way.

Teen grabs wheel when driver passes out and school bus veers into traffic

Cat climbed into Amazon return box, found alive 630 miles away

I learned to heal my sadness by cradling dying chickens 

In photos: At least 39 dead as historic flooding hits southern Brazil

Riot police and over 2,000 arrests: A look at 2 weeks of campus protests

Israel’s offensive is destroying Gaza’s ability to grow its own food

Insurance giant Aetna's announcement this week that it would <a href="https://www.washingtonpost.com/news/wonk/wp/2016/08/16/aetna-pulls-back-from-the-obamacare-exchanges/" target="_blank">sharply curb</a> its participation in the insurance exchanges set up under the Affordable Care Act was seen by some as payback to the Obama administration for blocking its proposed <a href="https://www.washingtonpost.com/news/business/wp/2016/07/21/justice-department-sues-to-block-anthem-acquisition-of-cigna/" target="_blank">merger with Humana</a>. After all, in April, Aetna chief executive Mark Bertolini had called selling insurance in the exchanges "<a href="http://seekingalpha.com/article/3969400-aetna-aet-mark-t-bertolini-q1-2016-results-earnings-call-transcript?part=single" target="_blank">a good investment</a>."

Rep. Frank Pallone Jr. (N.J.), ranking Democrat on the Energy and Commerce Committee, issued a statement Tuesday saying he was "troubled by reports this announcement could be in retaliation" to the Justice Department's decision. Earlier this month, after Aetna announced in an earnings call this month that it was reevaluating its participation in the exchanges, Sen. Elizabeth Warren (D-Mass.) wrote on <a href="https://www.facebook.com/senatorelizabethwarren/posts/630223030473527" target="_blank">Facebook</a>: "The health of the American people should not be used as bargaining chips to force the government to bend to one giant company’s will."

Now, a <a href="http://big.assets.huffingtonpost.com/AetnaDOJletter.pdf" target="_blank">letter</a> obtained by the<a href="http://www.huffingtonpost.com/entry/aetna-obamacare-pullout-humana-merger_us_57b3d747e4b04ff883996a13" target="_blank"> Huffington Post</a> through a Freedom of Information Act shows that the company's chief executive clearly explained to Justice Department officials in early July that if the merger were to be challenged or blocked, "we would need to take immediate actions to mitigate public exchange and ACA small group losses."

Bertolini clearly spells out what that means. Aetna would withdraw from many insurance exchanges, limiting its participation to no more than 10 states in 2017, rather than the 20 it had been planning.

Daron Taylor

"Finally, based on our analysis to date, we believe it is very likely that we would need to leave the public exchange business entirely and plan for additional business inefficiencies should our deal ultimately be blocked," Bertolini wrote. "By contrast, if the deal proceeds without the diverted time and energy associated with litigation, we would explore how to devote a portion of the additional synergies (which are larger than we had planned for when announcing the deal) to supporting even more public exchange coverage over the next few years."

Later in July, Justice Department officials blocked the merger. The company is fighting the decision. And the company <a href="https://www.washingtonpost.com/news/wonk/wp/2016/08/16/aetna-pulls-back-from-the-obamacare-exchanges/">announced</a> Monday evening that it would slash its participation in the exchanges to remain in just four states: Delaware, Iowa, Nebraska and Virginia. The company cited ongoing financial losses, adding up to $430 million in its individual insurance products since January 2014.

The question for many was why the company had soured so quickly on a business that its chief executive had been committed to in the spring.

Aetna spokesman T.J. Crawford said in an email that the possible $1 billion breakup fee for the merger and the loss of synergies from combining the companies "would raise further questions about sustaining a position in a business where we have yet to break even."

In the time since Aetna submitted the letter to the Justice Department, "we gained full visibility into our second quarter individual public exchange results, which … showed a significant deterioration," Crawford wrote.

Bertolini's letter was also a response to a demand for information from the Justice Department. Crawford provided that <a href="http://www.washingtonpost.com/blogs/wonkblog/files/2016/08/CID.pdf" target="_blank">letter</a>, in which the Justice Department asked the company to explain how "Aetna's business strategy and operations, including Aetna's participation on the public exchanges related to the Affordable Care Act and any products or geographic areas in which Aetna may withdraw or reduce operations" if the deal did not go through.

"Without getting into the heads of Aetna’s executives, it’s difficult to say whether they were just describing a financial fact that they would have to pull out of the ACA marketplaces if the merger were blocked, or if they were making a thinly veiled threat," Larry Levitt, a senior vice president at the Kaiser Family Foundation wrote in an email. "The letter certainly does provide some insight into how Aetna went surprisingly quickly from optimistic about the future of the ACA to reconsidering its options to pulling out from most markets."

<a href="https://www.washingtonpost.com/business/economy/high-prices-make-once-neglected-orphan-drugs-a-booming-business/2016/08/04/539d0968-1e10-11e6-9c81-4be1c14fb8c8_story.html">High prices make once-neglected ‘orphan’ drugs a booming business</a>

<a href="https://www.washingtonpost.com/news/wonk/wp/2016/08/02/how-theranoss-reboot-could-backfire/" target="_blank">How Theranos's reboot could backfire</a>

<a href="https://www.washingtonpost.com/news/wonk/wp/2016/07/19/obamacares-surcharge-for-smokers-may-have-backfired/">Obamacare’s surcharge for smokers may have backfired</a>

Finalist for the 2013 Pulitzer Prize in national reporting, as part of a team

Amherst College, BA in Physics and English

MIT, MS in Science Writing

Carolyn Johnson is a science reporter. She previously covered the business of health and the affordability of health care to consumers. 