(Bloomberg) — Aetna Inc. is quitting the health insurance industry’s main lobbying group, dealing a second blow to the organization just months after the exit of UnitedHealth Group Inc.

With Aetna’s departure, two of the five biggest public U.S. health insurers, covering about 65 million people, will have ditched America’s Health Insurance Plans. The other three — Anthem Inc., Cigna Corp. and Humana Inc. — are still members, according to Clare Krusing, an AHIP spokeswoman. The group represents about 200 members, including a number of smaller insurers and nonprofit insurance plans.

“AHIP’s successful advocacy record speaks for itself,” Marilyn Tavenner, AHIP’s chief executive officer, said in an e-mailed statement.

Cynthia Michener, a spokeswoman for Hartford, Conn.-based Aetna, declined to say why the insurer is leaving AHIP. Aetna’s departure was reported earlier Tuesday by Politico.

“Aetna has decided not to renew our AHIP membership,” Michener said in an e-mail. “We will continue to partner with groups that are working, as we are, toward expanding access to high-quality, affordable health care.”

Aetna, with about 23.5 million medical members, is set to acquire Humana this year. UnitedHealth has about 42.1 million U.S. health insurance customers, making it the largest in the country by that measure.

Management shakeup

Tavenner took over AHIP last year after Karen Ignagni left to run New York insurer EmblemHealth Inc. Two senior AHIP executives, Dan Durham and Mary Beth Donahue, both left the group last month, Bloomberg BNA reported.

When UnitedHealth left AHIP, the insurer said the lobby group’s advocacy was “limited and complicated.”

“The interest of our company and the customers we serve are no longer best represented by AHIP,” spokesman Matt Stearns said at the time. “AHIP has set forth a strategy and direction it feels best serves a membership profile and need that does not fit UnitedHealth Group and our diversified portfolio.”

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