Medica and Premera Blue Cross help cover bare spots on ACA exchanges, but others remain

Two health insurers have offered a partial reprieve for a pair of states that were at risk of having counties with no individual marketplace insurers next year.

For one, Medica has preliminary plans to continue selling policies on the Iowa's Affordable Care Act exchange next year, spokesman Larry Bussey told the Associated Press. Aetna and Wellmark Blue Cross and Blue Shield’s announcements that they will exit the state left the Minnesota-based insurer with a monopoly there in 2018, and it had considered an exit of its own.

That news, though, comes with considerable caveats.

“It is our intent to stay in Iowa, but we can’t make a final decision until we have clarity on the rules for the market,” Bussey said. Monday was the deadline in Iowa for insurers to file rate plans for next year, but they have until September to make a final decision about exchange participation.

In addition, Medica has sought an average rate increase of 43.5% for its individual plans in Iowa, according to the Wall Street Journal.

In Washington state, meanwhile, Insurance Commissioner Mike Kreidler’s “repeated discussions” with Premera Blue Cross led the insurer to agree to offer plans in one of the two counties in which it planned to exit next year, the article adds.

That still leaves Kreidler needing to fill a gap in the remaining county, however. He told the WSJ that he will work “diligently” with insurers in a bid to get them to offer coverage in that county next year.

With high levels of uncertainty making it difficult for insurers to decide where to participate and how to price exchange plans in 2018, Iowa and Washington are not the only states that are facing potential bare spots.

A new map from the Kaiser Family Foundation shows that as of Tuesday, 44 counties nationwide are at risk of having no exchange insurer next year, with most concentrated in Ohio and Missouri.

While Centene has said it will expand its exchange footprint in several states—including Ohio, Missouri and Washington—the insurer had not yet indicated which counties it plans to serve in those states, KFF notes, so when it does, the map could change.