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Anthem, MDwise Marketplace pulling out of Indiana's Obamacare exchange for 2018

Posted at 1:36 PM, Jun 21, 2017
and last updated 2017-06-21 23:33:05-04

INDIANAPOLIS -- Anthem Blue Cross and Blue Shield and MDwise Marketplace are pulling out of the Obamacare marketplace in Indiana, leaving just two carriers if they both decide to stay for 2018. 

Both companies released their decisions on Wednesday, citing uncertainty as a reason why they will be exiting the exchange. That uncertainty stems from what Anthem described as a volatile and shrinking market and not knowing whether the current administration will continue payments to insurers that currently compensate them for reducing the out-of-pocket costs for lower-income enrollees.

"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 stated in their release. 

Anthem has reduced its 2018 plan in Indiana to an off-exchange medical plan in Benton, Newton, White, Jasper and Warren counties.

Anthem says the change will not affect anyone who has employer-provided health insurance, Medicare Advantage, Medicare Supplement, Medicaid or those who enrolled in "grandfathered" plans that were purchased before March 2010. 

In their release, MDwise said the carrier lost $21 million on its Health Insurance Exchange business in 2016 alone. They also cite the "fewer than expected" number of enrollees since they joined Indiana's exchange in 2014. 

"When MDwise entered the Marketplace Exchange in 2014, it did so to provide continuity to its Medicaid members who no longer qualify for Medicaid and are looking to purchase coverage on the Marketplace Exchange.  Fewer members than expected have lost their Medicaid coverage and entered the Marketplace Exchange market," MDwise said in their statement. 

MDwise intends to focus on its larger Medicaid plans available to people in all 92 Indiana counties through two state programs, Hoosier Healthwise and the Healthy Indiana Plan. 

"It doesn't surprise me that MDWise and Anthem decided to do something a little bit differently," said Abdul Hakim-Shabazz. "Now, the question is what happens to those Hoosiers who were getting their insurance through the exchanges? What's going to happen in Washington, DC?"

The marketplace has already seen a drastic reduction in carriers from 2016 to 2017 with four pulling out before the beginning of the year

With the two carriers announcing their decision to exit on Wednesday, only CareSource and Celtic (MHS) remain in the marketplace for 2018. 

It's a big blow for the state, which has already seen premiums rise by almost 70 percent since the Affordable Care Act was signed into law in 2010, according to the Department of Insurance.

"We'll see. Obamacare, when it was passed, had hundreds of hearings, hundreds of amendments. And the Republicans are trying to pass a bill in a week," said Adam Kirsch.

RELATED | Higher costs and fewer choices on health marketplace for 2017

Gov. Eric Holcomb released the following statement in reaction to Wednesday's announcements from Anthem and MDwise:

"We'll know the full extent of the issues with the Obamacare marketplace tomorrow when all provider rates are published, but this 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. 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," said Holcomb.