August 25, 2017

After weeks of uncertainty, the last ACA 'bare' county is now filled

Daily Briefing

    The Ohio Department of Insurance (DOI) on Thursday announced that CareSource will sell 2018 exchange plans in Ohio's Paulding County, which was the last U.S. county at risk of having no exchange insurer for the 2018 coverage year.

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    CareSource President and CEO Pamela Morris said the company's "decision to offer coverage in the bare counties speaks to [the insurer's] mission and commitment to the [exchanges] and serving those who are in need of health care coverage." She added that the company wants to "be a resource to consumers left without options."

    Ohio DOI said it will work with insurers, including CareSource, over the next few weeks to finalize 2018 exchange plans and premium rates.

    Reaction

    Cynthia Cox, an insurance expert with the Kaiser Family Foundation, said, "At the end of the day, this is a business decision for [insurers]. They see this as an opportunity to expand and be profitable in the market."

    Leslie Dach, director of the Protect Our Care Campaign, said, President "Trump and Republicans in Congress have been rooting for health care to fail," but with this "announcement, their talking points continued to evaporate."

    The Trump administration, which in June pointed to the bare markets as a sign the Affordable Care Act (ACA) was failing, downplayed the announcement, citing rising premiums and decreased competition in the exchanges. HHS spokesperson Matt Lloyd in a statement said, "On Obamacare's exchanges premiums continue to surge, insurers continue to abandon wide swaths of the country, and choices continue to vanish." Lloyd continued, "Nearly half of counties across the nation only have one health insurance option which, by definition, is not a choice."

    Insurers still have time to enter, exit exchange markets

    According to the Wall Street Journal, CareSource's decision to enter Paulding County's exchange market does not completely quell concerns about U.S. counties' risk of having no exchange insurers for the 2018 coverage year.

    CMS has extended the deadline by which insurers must file premium rate proposals for 2018 exchange plans to Sept. 5, though individual states could choose not to allow the extension. Insurers also have until Sept. 27 to sign final contracts to sell 2018 exchange plans. That means insurers still could choose to either enter or exit the exchanges.

    Many insurers' decisions on whether to participate in the exchanges depend on whether the administration will continue to pay exchange insurers cost-sharing reductions called for under the ACA (Carr Smyth/Murphy, AP/Sacramento Bee, 8/24; Teichert, Modern Healthcare, 8/24; Hellmann, The Hill, 8/24; Demko, Politico, 8/24; Wilde Mathews, Wall Street Journal, 8/24; Ohio Department of Insurance release, 8/24).

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