MDwise and Anthem pull out of Indiana ACA marketplace

MDwise and Anthem Blue Cross and Blue Shield have announced they will pull out of Indiana’s 2018 Affordable Care Act exchange system.

Only people who purchase health insurance through the ACA marketplace will be affected, Seth Freedman, a SPEA professor who specializes in health policy, said. People who receive health insurance coverage through Medicaid, Medicare or their employers will not be affected by MDwise and Anthem’s withdrawal.

MDwise and Anthem’s members will remain on their current coverage until 2018, when they must choose different plans.

In 2017, most Hoosiers were able to choose from four options on the ACA marketplace. After MDwise and Anthem withdraw, Hoosiers who purchase their insurance on the ACA marketplace will now have only two health care providers to choose from. In many counties, they will only have one option, said Freedman.

Indiana was on average with other states when it had four options in the individual marketplace. With only two, it’s on the lower end but not out of the ordinary, Freedman said.

MDwise and Anthem cited political uncertainty as a reason for their withdrawal.

“The individual market remains volatile, making planning and pricing for ACA-compliant health plans increasingly difficult due to a shrinking and deteriorating 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 a press release.

MDwise also cited the growing uncertainty over the future of the federal exchange as reason for its withdrawal. In 2016, MDwise lost $21 million on its health insurance exchange business, according to an MDwise press release.

“The insurance companies don’t know what’s going on. They don’t know what’s happening next year,” Freedman said. “So they decided not to take that gamble.”

MDwise is still a part of the Medicaid program in Indiana, and Anthem remains an employer-provided insurer, said Freedman. Anthem will also continue to offer a one off-exchange medical plan in Benton, Newton, White, Jasper and Warren counties.

It’s unlikely that Hoosiers insured through the ACA marketplace will experience extreme changes to their premiums, Freedman said. ACA marketplace premiums are subsidized, so if the premiums’ costs rise, so do the subsidies.

“People will always be able to get a plan that’s the same percentage of their income,” Freedman said.

However, higher deductibles might affect Hoosiers insured through the ACA marketplace. And individuals might be unable to get the plan they had previously.

Senator Joe Donnelly, D-Indiana, reacted to the withdrawals, saying: “Today’s decision is especially disappointing because tens of thousands of Hoosiers are losing their coverage, an outcome forced by this Administration’s deliberate strategy to create chaos and undermine the health care coverage of Hoosiers,” in a June 21 press release.

Senator Todd Young, R-Indiana, has not yet released a statement.

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