Dive Brief:
- Harken Health, an independent UnitedHealthcare subsidiary, reversed expansion plans to offer ACA plans to individuals in Miami or Fort Lauderdale next year, the Miami Herald reported.
- In May, the insurance startup which offers individual health coverage, announced it would sell coverage as well as open 12 primary care clinics in the Miami-Dade and Broward counties, the Herald reported. Blog posts from Harken Health announcing the expansion plans in the South Florida markets are no longer available on the insurer's website.
- While reasons behind the reversal are currently unknown, Harken Health will instead plan to expand the number of its primary care clinics in Atlanta and Georgia, where its ACA products were launched earlier this year, according to the Herald.
Dive Insight:
“We have made a strategic decision to maintain a keen focus on our current markets of Atlanta and Chicago,” Harken Health Chief Marketing Officer Jeff Shoemate was quoted by the Herald. “Harken believes people in South Florida could benefit greatly from our innovative model, and we look forward to offering access to those services as part of future expansion,” he added, excluding timing details.
Many health insurers have been battling against significant financial losses that have been associated with the ACA marketplace's formative years, particularly the hurdles presented by the risk adjustment program, sicker-than-expected patients, to name a few. This has caused an overwhelming amount of insurers to request double-digit rate increases for 2017 or leave some ACA markets.
However, South Florida's ACA market is among those with the most competition in the exchange, the Herald noted, with 11 insurers requesting to sell plans for upcoming coverage year. In addition, the South Florida counties are big players in the ACA marketplace. According to February data from HHS, 643,911 individuals signed up for coverage in the Miami/Fort Lauderdale area on the ACA marketplace.
Competitiveness may have been a contributing factor to Harken Health's decision as insurers seek to make changes in prices. A market like Chicago looks like a hot market for insurers as carriers such as Cigna are looking to enter into its ACA marketplace. A Harken Health spokeperson hinted to the Herald the insurer could release more information over the expansion reversal this week.
The state's Office of Insurance Regulation is reviewing coverage rate proposals currently.