Two of the four insurers currently offering plans on Indiana’s Affordable Care Act health insurance marketplace announced Wednesday they were pulling their plans next year, citing uncertainty surrounding the future of Obamacare and volatility in the market.
MDwise and Indianapolis-based Anthem—the only two companies currently available in every Indiana county—announced within hours of each other they were leaving the exchange. The two companies collectively cover close to 77,000 people through their exchange plans.
As in many industries, healthcare relies on predictability and stability, Anthem spokesman Tony Felts explained in an email. “The individual market remains volatile, making planning and pricing for ACA-compliant health plans increasingly difficult due to a shrinking and deteriorating market,” Felts wrote. Company representatives declined an interview.
He added: “Changes and uncertainty in federal operations, rules and guidance, including cost-sharing reduction subsidies and the restoration of taxes on fully insured coverage” also contributed to the company’s exit.
Anthem CEO Joseph Swedish has publicly threatened to leave the exchange since the beginning of 2017. He’s been critical of the lack of clarity coming from the federal government regarding cost-sharing reductions, which reimburse insurers for subsidies that help people pay for premiums.
MDwise also cited the exchange’s uncertain future, adding it had lost $21 million on its exchange business in 2016 alone.
MDwise’s announcement stated the company originally entered the market to provide continuity to its Medicaid members who had lost eligibility, but “fewer members than expected have lost their Medicaid coverage and entered the marketplace exchange market.”
Currently all counties in Indiana have two or more choices in exchange providers—and most have three or more options. The dual exit of MDwise and Anthem puts four Indiana counties at risk of having no insurers at all in 2018.
Wednesday marks the state’s deadline for companies to submit their proposed rates for exchange plans, and it’s still possible other insurers will step into the at-risk counties. The state will release the full list of proposed rates—and participating insurers—on Thursday.
The company Centene—which operates in Indiana under the subsidiary name MHS—announced recently it intends to expand in more Indiana counties—but it’s unclear where it intends to offer coverage plans.
Politicians seized the news as a chance to criticize Obamacare. Governor Eric Holcomb released a statement in which he criticized the Affordable Care Act, saying the two departures were evidence of a broken system.
“Indiana is one of many states where Obamacare is failing to provide citizens options to affordable, quality healthcare,” Holcomb says. “This underscores the need for reform, and Indiana is poised to lead the way if given the flexibility and time to tailor the best solutions.”
The Indiana Democratic Party conversely blamed the GOP members of Congress for the news. In an email a spokesman accused Republicans of threatening to withhold subsidies to make their own ACA replacement bill appear more appealing.
The number of Indiana insurers offering plans on healthcare.gov has dropped from eight to four in the last two years.