Clean Up On Aisle 12! The Obamacare Pop-Up Store Is Open But Stocks Are Limited

Author:Mr Adam Shipley, Matthew J. Goldman and Jordan E. Grushkin
Profession:Sheppard Mullin Richter & Hampton
 
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The fifth Open Enrollment period under the Affordable Care Act (ACA) started on November 1st, and will continue for a scant 45 days ending on December 15, 2017. This year, not only has the Open Enrollment been cut in half, but obstacles abound - obstacles that were not part of the 2016 Open Enrollment Period. For example:

Healthcare.gov is undergoing maintenance that could interfere with access during the Open Enrollment Period; Federal support for Open Enrollment outreach and advertising is substantially lower this year than it has been in prior Open Enrollment periods; and The number of health insurers participating in the exchanges has dropped significantly from last year (prompted in part by well-founded concerns regarding the future of federal cost-sharing reduction (CSR) payments), and in some counties, only one plan is available to individuals and families seeking coverage through the exchanges. Plan Departure: A Continuing Trend from Prior Years

In 2016, a significant number of large, national insurance companies announced that they were withdrawing from the exchanges and would no longer offer health insurance coverage during 2017. As for 2018, the following chart identifies, as of October 12, 2017, both (1) those national insurance companies that will fully withdraw from one or more exchanges effective January 1, 2018, and (2) those national insurance companies that will continue to offer plans on the state exchanges in 2018 as they did in 2017.

Insurance Company:

Insurance Exchange Exits for 2018:

Insurance Exchange Participation in 2018:

Aetna

Delaware, Iowa, Nebraska, Virginia

None

Anthem

Indiana, Maine, Missouri, Nevada, Ohio, Wisconsin

California, Colorado, Connecticut, Georgia, Kentucky, Missouri, New Hampshire, New York, Virginia

Centene

None

Arizona, Arkansas, California, Florida, Georgia, Indiana, Kansas, Mississippi, Missouri, Nevada, New Hampshire, Ohio, Texas, Washington

Cigna

Maryland

Colorado, Illinois, Missouri, North Carolina, Tennessee, Virginia

Molina

Wisconsin, Utah

California, Florida, Michigan, New Mexico, Ohio, Texas, Washington

Humana

Florida, Georgia, Illinois, Louisiana, Kentucky, Michigan, Missouri, Mississippi, Ohio, Tennessee, Texas

None

UnitedHealthcare

Virginia

Nevada, New York

Who Ordered the Retreat?

There are a variety of reasons that large national insurers are retreating from the federal and state exchanges, but as a general rule, they stem from uncertainty regarding the profitability of state exchange participation.

CSR Funding...

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