Anthem exits all but 3 Nevada counties; 61 counties nationwide now set to have no ACA exchange insurer

Document titled, Affordable Care Act
As of Wednesday, 61 counties are at risk for having no ACA exchange insurer next year. (Getty/Designer491)

Anthem is continuing its retreat from the Affordable Care Act exchanges—and adding to the number of counties set to have no marketplace insurer next year.

The company announced Wednesday that it would stop offering on-exchange individual plans in all but three counties in Nevada, a significant retreat in that state given that it participated in all 17 counties last year.

In 10 of the 14 Nevada counties where Anthem is pulling out, it was the only on-exchange insurer last year, according to county-level data from the Kaiser Family Foundation. In the other four counties, Anthem's sole competitor also appears to have pulled out; thus, all 14 counties will join the growing list of those that are at risk for having no plan options in 2018 unless another carrier steps in.

Meanwhile, the three counties where Anthem plans to remain—Clark, Nye and Washoe—are the only ones where Anthem had two competing on-exchange carriers in 2017, KFF data show.

In a statement, Anthem said it made its decision to lessen its participation on the Nevada exchange “after significant dialogue with state leaders and regulators” in the state. As it did when it recently announced pullouts from the Wisconsin and Indiana exchanges, the insurer also cited the volatility of the individual marketplaces as a reason for its decision.

“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,” Anthem said in its statement.

The insurer also previously said it would pull out of Ohio’s exchange. In each state where it has either lessened or ended its exchange participation next year, however, Anthem said it would continue offering at least one off-exchange plan, which allows it to avoid the ACA’s five-year ban on re-entering the individual markets.

Those recent moves by Anthem come amid the insurer’s praise for the Senate’s ACA repeal-and-replace bill, which it said would help stabilize the exchanges. Anthem CEO Joseph Swedish, however, has also voiced concern about the implication of deep cuts to Medicaid that Republicans are planning.