Anthem Pulling Back on Offering ACA Plans in Nevada - Update
June 28 2017 - 9:16PM
Dow Jones News
By Anna Wilde Mathews
Anthem Inc. said it would stop selling Affordable Care Act
marketplace plans in most of Nevada next year. The move together
with the departure of a smaller insurer leaves 14 of the state's
counties poised to have no insurer on its exchange.
The state insurance marketplace, the Silver State Health
Insurance Exchange, said that insurers had filed to offer plans
only in Clark, Washoe and Nye counties, leaving the remaining,
largely rural region without any exchange options for 2018. Around
8,000 people living in the 14 potentially bare counties currently
have exchange coverage. Anthem had offered marketplace plans
throughout the state this year.
In addition to Anthem, a smaller insurer, Prominence Health
Plan, a unit of hospital company Universal Health Services Inc.,
will leave the Nevada exchange next year; Prominence had been
selling marketplace plans in seven counties, including four of
those that are now poised to lack exchange insurers.
Anthem's pullback in Nevada follows announcements that it will
completely exit the ACA marketplaces in Ohio, Wisconsin and
Indiana.
The 14 Nevada counties join an estimated 47 counties in Ohio,
Indiana and Missouri that currently appear at risk of having no
exchange insurers in 2018, according to the Kaiser Family
Foundation, after a series of withdrawal announcements. Still, the
situation remains fluid, since other companies may come in to fill
the gaps, as has happened in Tennessee and Washington state.
Anthem's latest announcement comes as Senate Republicans are
trying to push forward a health overhaul, and insurer exits and
rate-increase proposals have become flashpoints in the debate over
the bill. Republicans point to them as backing the need for their
legislation, while Democrats say the insurers are reacting to the
uncertainty created by Republicans -- including questions about the
future of federal payments that help with health costs for
low-income enrollees, which the Trump administration has threatened
to stop.
Nevada's situation may draw more of the spotlight because its
Republican Sen. Dean Heller has said he opposes the Senate bill,
which is now being reworked.
Nevada Republican Gov. Brian Sandoval called the insurers'
decisions "devastating and unfortunate." He said the state "will
pursue all available options to help the individuals and families
who will be hurt by this decision....Lack of coverage in rural
Nevada will set back the years of work we have done to reduce the
uninsured rate throughout our state."
David K. Livingston, the chief executive of Prominence, said the
insurer was exiting the exchanges in Nevada and Texas, the two
states where it participated, because of the uncertainty around the
future of the marketplaces, including the federal cost-sharing
subsidy payments and enforcement of the current ACA mandate for
individuals to have insurance. "There is not enough clarity on what
direction it's going that would allow us to continue to operate,"
he said.
Echoing comments it previously made around other withdrawals,
Anthem said its Nevada decision came as the "individual market
remains volatile." The company said that "planning and pricing for
ACA-compliant health plans has become increasingly difficult due to
a shrinking and deteriorating individual market, as well as
continual changes and uncertainty in federal operations, rules and
guidance, including cost-sharing reduction subsidies." Anthem also
said it was "pleased that some steps have been taken to address the
long-term challenges all health plans serving the Individual market
are facing."
Anthem is a major presence in its 14 state exchanges, with
nearly 1.6 million people enrolled in its ACA plans, 1.1 million of
those bought through the marketplaces. Overall, 302 counties in
states including Georgia, Missouri and Ohio currently have only
Anthem plans available in their marketplaces, according to the
Kaiser foundation. So far, the insurer has filed 2018 ACA plans
with regulators in other states, including Virginia, Maine and
Connecticut. Anthem has said it is evaluating its ACA plans on a
state-by-state basis.
Nevada's exchange said it is drawing two new insurers next year,
Centene Corp. and Aetna Inc., both in Washoe County, which includes
Reno, and also in Clark and Nye, which comprise one coverage region
that includes Las Vegas.
Outside of the marketplace, Nevada consumers trying to buy
individual plans in the 14 at-risk counties will likely have just
one choice: a bare-bones "catastrophic" plan, which Anthem will
sell off-exchange statewide next year, said Heather Korbulic,
executive director of the Silver State exchange.
Ms. Korbulic said state officials are exploring various possible
solutions, including talking to insurers about filling the coverage
gap. One option might be to apply for a federal waiver to alter
some aspects of the ACA's typical rules, she said, something that
officials in Iowa have done. "This creates a health-care crisis for
rural Nevada," she said.
Write to Anna Wilde Mathews at anna.mathews@wsj.com
(END) Dow Jones Newswires
June 28, 2017 21:01 ET (01:01 GMT)
Copyright (c) 2017 Dow Jones & Company, Inc.
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