Anthem announced Tuesday that it will leave the Obamacare exchange in Ohio next year and reduce its overall participation in the individual marketplace. The move would leave participants in 20 counties without any insurer.
The company cited uncertainty over the future of the law, referring to whether the Trump administration would continue making cost-sharing reduction payments, which allow insurers to offer lower out-of-pocket costs to customers. The company also cited an “increasing lack of overall predictability” as contributing to its decision, likely referring to whether Republicans would succeed in repealing Obamacare and whether it could count on the federal government to enforce the individual mandate that obligates Americans to purchase insurance or pay a fine.
“The current regulatory climate and the uncertainty it has produced in our industry do not give us the clarity and confidence we need to commit to offering broad-based, affordable health plans for 2018,” the company said. “So, while we wait for new regulations to be released, we’ve made the difficult decision to reduce the number of Individual health plans we’ll offer next year.”
The company appeared to leave the option open for re-entering the exchange, saying that if cost-sharing payments were paid it would “re-evaluate whether a more robust presence in the exchange is appropriate in the future.” Anthem is the only insurer that sells plans on the exchange, which are tax subsidized, in 20 Ohio counties, according to the Kaiser Family Foundation. If another insurer does not offer plans in those counties next year, residents who do not get coverage through the government or through an employer, or do not have a grandmothered or grandfathered plan, could have no health insurance options. In 28 additional counties, Anthem was one of two insurers that sold plans. Anthem is also the only insurer in other parts of the country, offering coverage to 275,000 people.
“As the individual marketplace continues to evolve, we look forward to seeing important changes made to the healthcare law,” the company said. “We hope these changes will stabilize the market and allow us to have a more robust presence in the future.”
The Department of Health and Human Services seized on the news as evidence that Obamcare isn’t working, and called for repeal of the healthcare law.
“This news is heartbreaking for the millions of Ohioans who depend on access to affordable, high-quality healthcare, and this is a stark reminder that Obamacare is collapsing,” Alleigh Marré, spokeswoman for the agency, said in an email. “Now is the time to advance real healthcare reform that empowers individuals and families with the choices and resources they need to buy a plan that meets their healthcare needs without breaking their budgets. The American people can’t afford to wait any longer.”
