Payer Roundup—Anthem pulls out of Virginia's exchange; Most want Trump administration to make ACA work

Donald Trump speaks at healthcare lunch
Sixty percent of Americans say President Trump and Republicans in Congress are responsible for any problems with the ACA going forward. (C-SPAN)

Anthem pulls out of Virginia's ACA exchange

Anthem has decided not to offer any health plans on Virginia's Affordable Care Act exchange next year.

"Today, planning and pricing for ACA-compliant health plans has become increasingly difficult due to a shrinking and deteriorating Individual market, as well as continual changes and uncertainty in federal operations, rules and guidance, including cost sharing reduction subsidies and the restoration of taxes on fully insured coverage," the company said in a statement to FierceHealthcare.

Therefore, Anthem will only offer an off-exchange plan in two Virginia counties next year. The insurer has already announced it will exit the exchanges in Nevada, Wisconsin, Indiana and Ohio next year, and will reduce its presence on the exchanges in California and Georgia. 

Majority of Americans want Trump admin to make ACA work

Seventy-eight percent of Americans say President Donald Trump and his administration should do what they can to make the Affordable Care Act work after Republicans in Congress failed to repeal the law, according to a new poll. In addition, 60% said it is a “good thing” that the Senate did not pass a bill that would have repealed and replaced the ACA, and the same percentage said Trump and Republicans in Congress are responsible for any problems with the ACA going forward. (Kaiser Family Foundation)

Many consumers forgo tax credits to buy off-exchange plans 

In 2015, 8.6 million nonelderly adults were enrolled in Affordable Care Act exchange plans and 6.3 million in off-exchange plans. Of those who bought off-exchange plans, 40.8% had incomes between 100% and 400% of the federal poverty level, meaning they would have been eligible to receive federal tax credits to help reduce their premiums if they bought on-exchange plans. Compared to enrollees in exchange plans, individuals who bought off-exchange plans were more likely to be male, to be white, have higher incomes, and be in excellent or very good health. (Health Affairs)

Health groups urge McConnell to stabilize individual market

Fourteen health organizations, including the American Heart Association, March of Dimes and United Way, sent a letter to Senate Majority Leader Mitch McConnell, R-Ky., urging him take steps to stabilize the individual health insurance market. These include ensuring continued funding for cost-sharing reduction payments; supporting coverage in counties without insurers; developing reinsurance programs; devoting adequate resources to outreach; expanding income eligibility for health insurance tax credits; and addressing other factors that contribute to rising healthcare costs. (Letter)

Evergreen Health CEO resigns

Peter Beilenson, M.D., the CEO and founder of Evergreen Health, has resigned. Evergreen was founded as a consumer-operated and -oriented plan, but the nonprofit insurer struggled financially and wound up suing the federal government over the Affordable Care Act’s risk adjustment program. To survive, the insurer attempted to transition to a for-profit company, but that plan fell through when its potential investors backed out—leading the Maryland Insurance Administration to ban Evergreen from selling or renewing any insurance policies. (Baltimore Business Journal)

Sanders wants supporters to join single-payer fight

Sen. Bernie Sanders, I-Vt., said in a recent email to supporters that he’s seeking “citizen co-sponsors” for a Medicare-for-all bill he plans to introduce soon. Though Republicans have repeatedly panned the concept of a single-payer system, calling it a government takeover, Sanders wrote that “it is time to wage a moral and political war against a dysfunctional health care system in this country.” That’s only possible, he noted, if the idea has strong public support. (USA Today)