Early filings offer hints about health insurers' ACA exchange participation next year

Affordable Care Act highlighted
Insurers have begun to submit preliminary filings in Kentucky and Virgina indicating whether they will sell Affordable Care Act exchange plans in those states next year. Image: Getty/Ellenmck

With the fate of a key Affordable Care Act subsidy still up in the air, health insurers have already submitted filings in some states indicating whether they will participate in the exchanges next year.

In Kentucky and Virginia, which have some of the earliest deadlines among state regulators, insurers’ preliminary filings offer the first clues about what the individual marketplaces will look like next year, according to The Wall Street Journal.

Anthem has submitted filings indicating it will operate in both states next year, while Cigna and Aetna have done the same for Virginia. The article notes, though, that the insurers could change their minds in coming months. They also have not yet had to disclose their rates or say which areas in the state where they will offer plans.

The leaders of all three companies had said on their most recent earnings calls that they had not yet decided the extent of their participation on the ACA exchanges next year, in part due to regulatory uncertainty. A recent report from Jefferies also said it appeared Anthem, one of the major players on the exchanges, was poised to exit many markets next year. 

Aetna already pulled out of many marketplaces in 2017, and CEO Mark Bertolini has said the individual market is in a “death spiral.” A recent report from S&P analysts, however, refuted that claim and noted that for many insurers, their individual market performance is turning a corner.

UnitedHealth, meanwhile, which only sold plans in three states in 2017 after also paring down its exchange participation, will now exit one of those states—Virginia—a spokesman confirmed to the WSJ. The other two states where it offered individual market policies this year are New York and Nevada.

RELATED: Following ACA exchange exits, UnitedHealth beats Q1 earnings expectations

Earlier this year, the federal deadline for qualified health plan applications was pushed back from May 3 to June 21 to give plans more time to make decisions about the exchange participation. Even so, many insurers see April 30 as a key deadline for Congress and the Trump administration to make a decision about whether to fund cost-sharing reduction (CSR) payments next year.

Those subsidies, which the government pays to insurers so they can reduce consumers’ out-of-pocket costs, are the subject of a court case challenging their legality that is currently in limbo. President Donald Trump has suggested he is withholding a decision about funding the subsidies in a bid to get Democrats to negotiate with him on healthcare. And during a meeting with insurers Tuesday, Centers for Medicare & Medicaid Services Administrator Seema Verma said it will be up to Congress to decide whether to appropriate funding for CSRs.

To that end, the National Association of Insurance Commissioners has joined other major healthcare trade groups in urging congressional leaders to ensure CSRs are adequately funded.

“The time to act is now,” the group wrote in a letter (PDF) sent Wednesday, adding that “funding the cost-sharing reduction payments will go a long way toward stabilizing the individual markets in our states while legislative replacement and reform options are debated in Congress.”