Of states where insurers had been announced for exchanges, Mississippi had been the only one with areas that no insurer had filed to serve. That coverage void had prompted concern among some state and federal officials.
"They're good corporate citizens, and there's money to be made," state Insurance Commissioner Mike Chaney said of Humana. He said a number of people had worked together to persuade the company to step forward.
Until Friday, insurers had announced plans to cover 46 of the state's 82 counties. Humana had previously said it would cover people in four urban counties — Hinds, Madison, Rankin and DeSoto.
Magnolia Health Plan, a unit of St. Louis-based Centene Corp., has said it will serve 46 counties, including the four that Humana had already designated. Centene already runs a Mississippi Medicaid network with 77,000 enrollees.
Areas that will gain coverage because of Humana's announcement include swaths of the Delta region and southwest Mississippi, plus scattered areas elsewhere. Among those areas are Corinth, Greenville, Laurel, Natchez and Picayune.
People with incomes between 133 percent and 400 percent of the federal poverty level will be eligible for federal tax credits, on a sliding scale, to help pay for coverage purchased through the online marketplace. That's income of up to about $46,000 for an individual and about $94,000 for a family of four, with those at the top end getting little or no subsidy.
Under the federal healthcare law that President Barack Obama signed in 2010, every state is required to have an online marketplace so people can get coverage starting in January 2014, much of it federally subsidized. A 2012 study by the Mississippi Center for Health Policy had projected that as many as 275,000 Mississippians could gain insurance through exchanges, with 230,000 of those benefiting from federal tax credits that could total $900 million a year.
The marketplace program is separate from proposals to expand the state-federal Medicaid program to cover people with incomes up to 138 percent of poverty.
In February, the federal government rejected Chaney's effort to create a state-based exchange in Mississippi because of opposition by fellow Republican Gov. Phil Bryant. That means Mississippi's market will be run by the federal government.
Chaney said the department has been told that the state's two largest private insurers, Flowood-based Blue Cross & Blue Shield of Mississippi and UnitedHealth Group of Minnetonka, Minn., would not offer plans on the online marketplace beginning in October.
Because Mississippi is a small, poor state with relatively few insurers, there wasn't a flood of new entries. Any new insurer would have to try to sign up a network of doctors and hospitals, and could have a hard time negotiating favorable payment rates because it would have few customers at the beginning. That's not a problem for Humana, though, which handles insurance for military retirees, employer groups and Medicare beneficiaries in the state. The company said it already covers more than 200,000 people in Mississippi.
Chaney said widening participation in the marketplace could help Humana build up its business in the state, especially in the commercial market where it competes against Blue Cross.