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The Journal Gazette

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Thursday, June 22, 2017 1:00 am

MDwise, Anthem drop state exchange

Half of Indiana's insurers for ACA covered 77,000

BRIAN FRANCISCO | The Journal Gazette

Two of the four insurers that offer medical coverage in Indiana through the Affordable Care Act announced Wednesday they will leave the Hoosier marketplace in 2018.

Anthem and MDwise each said it will stop selling federal exchange insurance in Indiana next year because of “uncertainty” over the national health care program, which congressional Republicans are trying to repeal and replace. Between them, Anthem and MDwise insure about 77,000 of the roughly 147,000 Hoosiers who are enrolled in ACA plans, which are intended for people who cannot obtain affordable insurance through their employers.

The pending departures would leave CareSource and Ambetter from MHS as the only providers of ACA individual insurance policies in Indiana, assuming those insurers remain in the exchange. Wednesday was the deadline for insurers to submit proposed prices for 2018 ACA medical coverage to the Indiana Department of Insurance. 

Fort Wayne-based health insurance broker Ryan Stoneburner said CareSource and Ambetter provide nearly all of the insurance plans bought by his customers who are enrolled in the federal exchange. He said the loss of Anthem and MDwise “is not a terrible thing” for northeast Indiana as long as CareSource and Ambetter remain options.

“It's not good; it's healthier to have more competition,” said Stoneburner, owner of Health Insurance Inc.

Douglas Powers, an employee benefits compliance attorney for local law firm Beckman Lawson, said in an email, “Any time insurers leave a market, there is a risk of increased cost due to reduced competition.”

Powers said that “the fact that the region still has two viable competitors will minimize, but not eliminate, the risk of significant premium increases. … Many areas of the country have only one carrier remaining in their marketplace exchanges, and that is a much more serious issue.”

Stoneburner said Anthem priced itself out of parts of the Indiana market this year. The insurer raised its premiums by an average of 29 percent for 2017.

Fort Wayne medical system Lutheran Health Network is affiliated with Anthem, MDwise and Ambetter.

“While Lutheran Health Network has a significant number of patients who have health insurance through Anthem, a very small percentage of those individuals have purchased it through the ACA marketplace in Indiana,” Lutheran spokesman Geoff Thomas said in an email.

Fort Wayne medical system Parkview Health is associated with CareSource. 

Nearly 20,000 residents of northeast Indiana, including more than 10,500 residents of Allen County, signed up for federal insurance exchange plans in the ACA open-enrollment period that ended Jan. 31, according to the U.S. Department of Health and Human Services.

Anthem said Wednesday in a news release it would leave a “volatile” ACA marketplace in Indiana because of “a shrinking and deteriorating market as well as continual changes and uncertainty in federal operations, rules and guidance.” Anthem announced it also would stop selling ACA policies in Wisconsin, and the Indianapolis-based company said last week that it would quit selling them in Ohio.

MDwise said in a statement that its decision to exit Indiana was “influenced by the growing uncertainty over the future of the federally subsidized exchange. In 2016 alone, MDwise lost $21 million on its Health Insurance Exchange business.”

Federal lawmakers have been wrangling for years over whether and how to repeal and replace the Affordable Care Act, nicknamed Obamacare because it was a signature piece of legislation for former President Barack Obama and what was a Democratic Congress when the ACA was passed in 2009. The current Republican Congress and White House are pushing for passage of the American Health Care Act, which in its latest form would reduce Obamacare subsidies, cut or eliminate its taxes and allow states to opt out of certain insurance coverage requirements. 

Indiana elected officials weighed in soon after the Anthem and MDwise announcements were made.

Republican Gov. Eric Holcomb said in a statement that the contraction of Indiana marketplace insurers “is more evidence that the current federal system isn't working. Indiana is one of many states where Obamacare is failing to provide citizens options to affordable, quality healthcare.”

Rep. Jackie Walorski, R-2nd, said in a statement, “Obamacare is collapsing, and I am committed to replacing it with a patient-centered system that lowers costs, increases choices, and provides real protections.”

Sen. Joe Donnelly, D-Ind., blamed the pending Anthem and MDwise departures on President Donald Trump's administration.

“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,” Donnelly said in a statement.

Rep. Todd Rokita, R-4th, who is considering running for Donnelly's Senate seat next year, said in a statement that “Obamacare is taking away coverage and Hoosiers' right to choose their provider.” Rep. Luke Messer, R-6th, who is considering a bid for Donnelly's seat, said in a statement that the Anthem and MDwise announcements “confirm what most Hoosiers already knew: Obamacare is broken beyond repair.”