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Preliminary Filings From Insurers Hint at Things to Come for PPACA Marketplaces

Insurers reluctant to dive into murky waters

Insurers are struggling to make decisions about their 2018 exchange offerings amid mixed signals from the Trump administration and congressional Republicans about the future of the Patient Protection and Affordable Care Act (PPACA), according to an article in the Wall Street Journal. Still, preliminary filings by major insurers have provided hints of what may be store for the PPACA exchanges.

In the past, Anthem, Cigna, and Aetna all said they were reconsidering their exchange offerings. In preliminary filings, Anthem has indicated that it will offer plans on the PPACA marketplaces in Virginia and Kentucky next year, providing an early glimpse of the insurer’s exchange business, according to the Journal. Cigna and Aetna made similar filings in Virginia. On the other hand, one current Virginia insurer, UnitedHealth Group, has confirmed that it will leave the state’s marketplace next year. This year, the company abandoned all but a handful of its PPACA exchanges.

Anthem, a Blue Cross Blue Shield licensee, is being closely watched by government officials and investors as it makes decisions about 2018, the Journal says. The company has announced that it is considering pulling back from the marketplaces if the business doesn’t stabilize. The company’s final decisions in Virginia and Kentucky will be important because it is the only exchange insurer in 28 Virginia counties and 59 Kentucky counties, according to data from the Kaiser Health Foundation.

Another Kentucky exchange insurer, Humana, previously announced that it is pulling out of all exchanges next year.

Aetna, which quit most of its state exchanges this year, has said it will leave at least one more state, Iowa, in 2018. Aetna also sells exchange plans in Delaware and Nebraska. 

Cigna offers exchange plans in seven states. A Cigna spokesman told the Journal that final plan decisions typically occur during the third quarter of the year.

President Trump has threatened to stop funding the PPACA’s cost-sharing reduction subsidies, which help lower-income PPACA enrollees with expenses, such as insurance deductibles, in an effort to prod Democrats to negotiate over a new health bill. A White House spokesman said earlier this week that the PPACA is “already collapsing on its own” and that the president will work with Congress on replacement legislation.

Source: Wall Street Journal; April 20, 2017.

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