Two major insurers, Anthem and Cigna, are planning to reduce their Affordable Care Act exchange footprints in 2018—if only slightly.
Anthem will almost entirely pull out of the individual markets in Wisconsin and Indiana, according to a statement sent to FierceHealthcare. However, it will continue offering one off-exchange plan in each state. allowing Anthem to avoid a five-year ban from re-entering the individual markets that would have faced if it exited completely.
Anthem said the reason for its decision was the volatility of the individual marketplaces and uncertainty about factors including whether cost-sharing reduction payments would continue to be funded. The insurer made a similar argument when it announced earlier this month that it would pull out of Ohio’s ACA exchange in 2018.
Even so, Anthem—which is one of the major players in the exchanges—could have gone much further. In fact, Jefferies analysts wrote in a research note in March that based on conversations with Anthem executives, the insurer was “leaning toward exiting a high percentage” of the 144 rating regions in which it participated in 2017.
“In those states where Anthem has not yet made a final participation decision, we continue to work with regulators and remain actively engaged in dialogue,” Anthem noted in its statement.
Cigna, meanwhile, will not return to Maryland’s individual marketplace next year, the Washington Business Journal reports. The insurer had requested an average rate increase of 37% for its individual plans, but the Maryland Insurance Administration told the publication on Wednesday that Cigna had withdrawn its application for the rate increases.
In a letter to state regulators, Cigna noted that financial losses for its ACA exchange business in Maryland has continued to increase year over year. It also cited “competitive developments and marketplace volatility” as reasons for its Maryland exit, the article says.
Despite all the volatility, some insurers, like Oscar Health and Centene, have opted to expand their ACA exchange footprints. Others, including Medica and Premera Blue Cross, have stepped up to offer plans in counties where other insurers exited—however, dozens of counties still are at risk of having no exchange options next year.
Wednesday was the deadline for many states to file their initial rate requests with the federal government, but final decisions about plan prices and insurer participation won’t be final until the fall.