Over the last few years, we’ve witnessed major health insurers withdrawing from offering coverage on various states’ exchanges under the Affordable Care Act. Companies like UnitedHealth and Aetna arguably led the charge, where certain pockets within the country were left with little or no competitive market for health care options. States like Washington, Missouri, and Ohio are suffering in certain counties across their states with a dearth of options for coverage, and may have none to work with in the coming year if no companies step up for 2018. And while affiliates of Blue Cross-Blue Shield have also followed in previous exits, some of them may be coming back.
Health Care Services Corp. (HCSC), one of Blue Cross-Blue Shield’s significant affiliates, says they will possibly enter the exchanges of places like Montana, New Mexico, and Oklahoma—the latter making them the sole option in the OK exchange. HCSC is also targeting larger markets like those in Illinois and Texas. They are not alone, however, as many insurers are also pondering the same entries/re-entries. Their hesitation in decision to enter/re-enter comes from the question of federal funding, along with some of the potential hits they may still take while under the Affordable Care Act’s mandates.
UnitedHealth had previously voiced concern of financial loss for those exchanges from which they had previously withdrawn. And while major insurers exiting exchanges did give rise to smaller boutique agencies having a shot at success in these markets, there are still some parts of the country where 2018 will bring no options whatsoever.
However, no celebrations for the returning insurers should happen just yet. HCSC and other companies have until the Fall to make their decisions for 2018 coverage within the ACA exchanges. While nothing is set in stone, there should be some cautious optimism that providers are learning the value of their presence in both major and minor markets.
