Two health insurers expand Obamacare presence while others retreat

While some health insurers are bailing on the Affordable Care Act exchanges, others are swooping in to take the business they leave behind.

Medicaid and exchange insurer Centene Corp. and New York-based startup Oscar Health plan to expand their footprints on the ACA marketplaces in 2018. Others, including Molina Healthcare and Highmark Health, indicated that they'll continue to sell coverage in each of the states where they currently operate.

Insurers had until Wednesday to announce whether they planned to sell coverage on the insurance exchanges next year. Several, including Aetna and Humana, had previously said they would stop selling individual plans in certain markets in 2018, citing financial losses and uncertainty over whether key provisions of the healthcare law would remain in play.

Insurer exits continued yesterday as Anthem, which covers 1.1 million exchange members, pulled out of marketplaces in Indiana and Wisconsin because of a "shrinking and deteriorating individual market" and lingering questions over funding for the cost sharing reduction subsidies and the future of taxes on fully-insured health coverage. Anthem previously announced it would stop selling plans in Ohio, as well.

Anthem filed preliminary rates in the 11 other states where it currently sells health insurance on the individual market.

MDWise, an Indianapolis-based insurer, pulled out of Indiana's exchange, saying it lost $21 million on exchange plans in 2016 alone. Its exit will affect 30,800 members. Just two other insurers, CareSource and Centene Corp., sell plans in the state's marketplace this year.

Insurer exits have left 44 counties in Ohio, Missouri and Washington, where more than 31,200 people get coverage, with no insurance options next year.

For its part, Centene on Tuesday said it will start offering coverage on exchanges in Kansas, Missouri and Nevada, while expanding in Florida, Ohio, Texas and Washington, where it currently sells plans. Centene now covers 1.2 million exchange members.

Centene has lots of experience managing the care of low-income Medicaid members—a skill set experts say equips the insurer to succeed on the exchanges, which are also made up of low-income, sicker-than-usual enrollees. Centene's narrow network, low-premium plans have helped it profit from the exchanges while other insurers have suffered financial losses.

Despite losing millions on the insurance exchanges in 2016 and 2015, Oscar Health on Wednesday filed to expand into certain counties in Ohio, New Jersey and Tennessee. The startup, founded by Joshua Kushner, previously sold plans in New Jersey but exited the market this year. Oscar will also expand its presence in California and Texas and will keep selling plans in New York. In 2017, Oscar covered about 105,000 members.

Last week, Oscar also announced the launch of a joint venture health plan with Ohio's Cleveland Clinic. The plan will offer individual coverage on and off the state's exchange.

Long Beach, Calif.-based Molina filed preliminary rates in each of the nine states where it currently sells coverage on the exchanges. And Pittsburgh-based Highmark Health filed rates in the three states where it operates, including Delaware, Pennsylvania and West Virginia.

Chicago-based Health Care Service Corp. also filed rates in the five states where it sells exchange coverage, but a spokeswoman for the insurer said no final decisions have been made regarding participation or products.

The rates filed Wednesday will likely change following regulatory review. Some states will release the rates publicly in a matter of days or even weeks. Final information on premiums and insurer participation likely won't emerge until close to open enrollment, which begins Nov. 1, said Cynthia Cox, an associate director at the Kaiser Family Foundation.