Anthem to withdraw from Ohio health care exchange at end of year

Posted at 2:10 PM, Jun 06, 2017
and last updated 2017-06-06 14:38:46-04

CINCINNATI -- Anthem Blue Cross and Blue Shield will pull out of Ohio’s Health Insurance Marketplace at the end of this year, following in the footsteps of competitor, Aetna, which pulled out of the federal health insurance exchange created by the Affordable Care Act this year, the company announced Tuesday.

Anthem, with about 67,000 members on Ohio’s health insurance exchange, will continue to offer one off-exchange individual health insurance plan in Ohio in Pike County next year, the company said, noting its decision to drop out of the state exchange does not impact individuals or families with grandfathered plans.

Anyone with employer-provided insurance, Medicare or Medicaid will not be impacted, according to state officials.

The move will leave at least 18 counties with no insurer on the ACA exchange in 2018, according to the Ohio Department of Insurance. None are located in Greater Cincinnati. They are: Coschocton, Crawford, Guernsey, Hancock, Harrison, Hocking, Holmes, Jackson, Knox, Lawrence, Morgan, Muskingum, Noble, Paulding, Perry, Van Wert, Vinton and Wyandot.

“A stable insurance market is dependent on products that create value for consumers through the broad spreading of risk and a known set of conditions upon which rates can be developed,” Anthem said in a statement. “Today, planning and pricing for ACA-compliant health plans has become increasingly difficult due to the shrinking individual market as well as continual changes in federal operations, rules and guidance.”

The company was referring to the uncertainty surrounding President Donald Trump’s-endorsed GOP plan to replace Obamacare, which has led several other major insurers to pull out of exchanges in other states.

“We are pleased that some steps have been taken to address the long term challenges all health plans serving the individual market are facing, such as improving the eligibility requirements that allow consumers to purchase a plan outside of open enrollment and improved risk adjustment,” the Anthem statement continued. “However, the Individual market remains volatile and the lack of certainty of funding for cost sharing reduction subsidies, the restoration of taxes on fully insured coverage and, an increasing lack of overall predictability simply does not provide a sustainable path forward to provide affordable plan choices for consumers.”

Anthem is not alone in dropping off ACA exchanges in Ohio. This year, the number of companies selling health insurance on the federal exchange in Ohio dropped from 17 to 11. Twenty counties had just one insurer; another 27 counties had just two. 

Still, Anthem reserved the right to return to Ohio’s insurance exchange at a later date: “As the Individual marketplace continues to evolve, Anthem will continue to advocate solutions that will stabilize the market to allow us to return to a more robust presence in the future.”

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