Anthem will not sell individual Obamacare plans in ME next year

Consumers in 42 counties will have access to only one carrier, according to the Florida Office of Insurance Regulation, which releases its projections each year. He and congressional Republicans have been unable to deliver on their promise to “repeal and replace” the 2010 health care law.

The Sunshine State has led the country in enrollment on the Affordable Care Act exchange with almost 1.7 million consumers.

The company as it has done in announcing departures from a number of other states’ individual health plan markets in recent months, cited a “volatile” individual market that is “shrinking and deteriorating”.

Roughly 80,000 ME residents purchased health insurance a year ago through Healthcare.gov.

Anthem’s decision, which came on the day of the deadline for insurers to sign contracts for Obamacare plans in 2018, will leave ME with just two insurers selling plans widely when open enrollment starts November 1.

Anthem and the other insurers stated in earlier regulatory filings that they expect Maine’s individual market to dwindle while growing more expensive to cover.

Six insurance companies are offering Obamacare plans in 2018. That’s expected to leave primarily sicker, older people who most need insurance as customers in the Obamacare market. In 2017, a third of counties had only one insurer.

The subsidies help low-income enrollees afford out-of-pocket costs such as deductibles and copays. But those figures don’t include subsidies given by the federal government to help consumers pay for their plans.

“Today, planning and pricing for ACA-compliant health plans has become increasingly hard due to a shrinking and deteriorating individual market, as well as continual changes and uncertainty in federal operations, rules and guidance, including the restoration of the health insurance tax on fully insured coverage and continued uncertainty around the future of cost sharing reduction subsidies”.

Anthem covered more than 28,000 consumers in the individual marketplace a year ago, almost one-third of all enrollees. The plan is categorized as a “gold” policy under the ACA, generally providing generous coverage but with higher premiums. Almost half of US counties have no choice, with only one insurer offering individual plans.

Under Maine’s guaranteed renewal law, current individual members will be able to renew their health plan in 2018, Anthem said. Government subsidies, amounting to about $7 billion a year ago – $1.5 billion of which went to Florida – have been funding those discounts. “This has resulted in higher rates, and also in fewer choices”, Cioppa said.

Anthem said it will not sell new customers plans next year through HealthCare.gov, the federally run Obamacare exchange that serves ME and most other states.

Still, insurance commissioners in Republican-leaning states such as Tennessee, Missouri, and Virginia spent months negotiating with insurers to see who might pull out of their markets and either convince them to stay, or find a replacement.

State health commissioners allowed them to propose monthly premium increases of 20 percent, or even more, from 2017 to compensate for the uncertainty.

Cioppa then asked the insurers to submit a second set of rates that assumed the subsidy payments would be eliminated.

“As the marketplace continues to evolve and adjust to changing regulatory requirements and marketplace conditions, we will reevaluate whether a more robust presence in the exchange is appropriate in the future”, Manning said Wednesday.

Overall, consumers enrolled in bronze, gold and platinum plans across Florida will have an average increase of 18 percent. The state has the power to negotiate those rates down to a lower price.

Harvard Pilgrim plans to increase rates by almost 40 percent.

“It’s still a very uncertain market”, said Tony Jenkins of Florida Blue. “However, continuing to offer high-quality, high-value health insurance options that meet the varying needs of ME residents is consistent with our mission and values”.

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