What you need to know about the forces reshaping our industry.


June 21, 2017

As deadline looms, insurers step forward to sell plans in would-be 'dead zones'

Daily Briefing

    Ahead of a federal deadline to file plans to sell exchange coverage on for 2018, some insurers have indicated they intend to sell plans in markets that were in danger of having so-called exchange plan "dead zones."

    Join us on June 29: The future of health insurance


    CMS in an analysis released last week estimated that 47 counties in Ohio, Missouri, and Washington could have no insurers selling Affordable Care Act (ACA) exchange plans for the 2018 coverage year. CMS also predicted that as many as 1,200 counties throughout the country could have just one insurer selling 2018 exchange plans.

    The analysis was based on a review of public insurer announcements made as of June 9 regarding the companies' exchange participation for 2018. Insurers have until Wednesday to file plans to sell 2018 exchange coverage, so the figures included in the analysis are likely to change. In addition, regulators could choose to accept late filings, the New York Times reports. Similarly, insurers still could choose to pull out of markets. Insurers do not have to sign contracts to sell federal exchange plans until late September.

    CMS said it will update the analysis as more insurers announce whether they intend to sell 2018 exchange plans.

    Some insurers say they will sell exchange plans in 'dead-zone' markets

    Washington Insurance Commissioner Mike Kreidler on Monday announced that Premera Blue Cross has agreed to sell two 2018 exchange plans in the state's Grey Harbor County, which was at risk of having no insurers for the 2018 coverage year. According to Politico "Pulse," Washington still has one county, Klickitat County, where no insurer has yet to announce plans to sell 2018 exchange coverage.

    Further, Anthem—which sold 2017 exchange plans in 85 of Missouri's 114 counties—has said it will sell 2018 exchange plans in the state, but has warned that it could change that decision or choose to increase premiums. According to the St. Louis Post-Dispatch, Anthem already has indicated it will increase premiums for 2018 exchange plans when compared with 2017 premiums, but a spokesperson for the company has not offered details on the rate hikes.

    In addition, Medica has indicated it will sell 2018 exchange plans throughout Iowa, reducing the chances that some of the state's counties will have no exchange insurers for 2018. Medica has requested an average 43.5 percent increase on premiums for 2018 individual health plans. According to Politico Pro, Medica said the rate hikes are needed to protect the insurer from financial risk associated with uncertainty in the exchange market. Geoff Bartsh, Medica's vice president of individual and family business, said, "We know this will impact people who do not currently receive a subsidy particularly hard," adding, "The bottom line is that the individual market still needs reform."

    According to Politico, Medica also has said it will sell 2018 exchange plans throughout Nebraska.

    Meanwhile, Oscar Health on Wednesday announced that it plans to sell 2018 exchange plans in six states, including some new markets for the company. In addition to continuing to sell coverage in New York, Oscar said it would expand its offerings or enter new markets in:

    Be prepared for any scenario: Get the new Clinical Leader's Resource Guide

    Clinical leaders at every level should be preparing for a world in which insurance may be less generous, patients will act more like consumers, hospitals will face tighter margins, and workloads will be heavier and more complex.

    To help you and your clinical teams operate in this uncertain time, we've created The Clinical Leader's Resource Guide. Inside you'll find the information and no-regrets strategies needed to support clinical outcomes and financial success in any regulatory environment.

    Download the Briefing

    Have a Question?


    Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.