WYSO

Anthem Blue Cross And Blue Shield To Exit Ohio's Health Insurance Exchange

Jun 7, 2017

Anthem Blue Cross and Blue Shield has announced plans to exit the state health insurance exchange by the end of this year. The decision could leave some people in 18 counties with private individual Affordable Care Act plans with limited private, non-employer health insurance options in the future.

Anthem’s departure is not expected to affect Ohioans with coverage through employer-sponsored health plans, Medicare or Medicaid -- that’s most Ohioans.

Health Policy Institute of Ohio President Amy Rohling McGee says people who lose their Anthem marketplace plans may also still be able to access private plans outside of the exchange. But she says that might not be the best option for everyone.

“Those plans may not be affordable to people because they won’t be able to get that financial assistance to help pay into the premiums or any kind of co-pays or deductibles associated with those plans,” she says. 

In a statement, Anthem officials say uncertainty around the future of the Affordable Care Act, also known as Obamacare, was a factor in the decision to pull out of Ohio’s marketplace. Senate lawmakers are considering a Republican measure to repeal and replace the Affordable Care Act.

Anthem says affected policyholders will receive a notice with more information about their plans soon.

In a statement, Anthem spokesman Jeff Blunt says the company will continue to monitor the individual plan market and advocate for, "solutions that will create stability and allow us to expand coverage options in the future."

The statement also says:

"For more than seven decades, Anthem Blue Cross and Blue Shield has served consumers in the Individual market and throughout that time our commitment remained the same: to provide access to affordable, quality healthcare. And, since the inception of the exchanges, Anthem continued its commitment to serve consumers in all of the states where we provide fully insured individual health plans. A stable insurance market is dependent on products that create value for consumers through the broad spreading of risk and a known set of conditions upon which rates can be developed. Today, planning and pricing for ACA-compliant health plans has become increasingly difficult due to the shrinking individual market as well as continual changes in federal operations, rules and guidance. We are pleased that some steps have been taken to address the long term challenges all health plans serving the individual market are facing, such as improving the eligibility requirements that allow consumers to purchase a plan outside of open enrollment and improved risk adjustment. However, the Individual market remains volatile and the lack of certainty of funding for cost sharing reduction subsidies, the restoration of taxes on fully insured coverage and, an increasing lack of overall predictability simply does not provide a sustainable path forward to provide affordable plan choices for consumers. As a result, Anthem has made the difficult decision to reduce its 2018 Individual plan offering in Ohio to one off-exchange medical plan in Pike County only. This decision does not impact individuals or families with grandfathered or grandmothered plans. As the Individual marketplace continues to evolve, Anthem will continue to advocate solutions that will stabilize the market to allow us to return to a more robust presence in the future."