Centene Corp. will offer Affordable Care Act (ACA) exchanges plans in 40 counties in Missouri, including 25 “bare counties” which were facing the possibility of having no ACA exchanges options in 2018.
Blue Cross Blue Shield of Kansas City announced earlier this year that it is dropping ACA exchanges plans in 32 counties in Missouri and Kansas next year. Those 32 counties include the 25 Missouri counties that Centene will now cover.
- It's not all good news for the exchanges. Centene’s announcement comes days after Anthem announced it is dropping ACA exchanges plans in 14 Nevada counties next year, which will leave 10 counties in that state with no exchanges option.
While major payers like Anthem, Aetna and Humana have pulled back or are completely out of ACA exchanges next year, Centene is expanding its footprint in the exchanges.
Centene, which is based in St. Louis, has 12.1 million members across 25 states, with 9.3 million members in Medicaid plans. The rest of its members are in ACA exchanges, Children’s Health Insurance Program, Medicare Part D and the Department of Veterans Affairs.
Centene currently has 1.2 million members in exchanges plans, which is an increase from 537,200 at the end of 2016. In addition to the Missouri news, the payer plans to enter Kansas and Nevada next year and expand its footprints in six existing markets: Florida, Georgia, Indiana, Ohio, Texas and Washington.
The insurer has found success in ACA markets. In April, the company announced 69% growth in the first quarter of the year compared to the same period last year. Centene was also able to reduce its health benefits ratio from 88.7% last year to 87.6% in the first quarter of this year.
Centene’s announcement means Missouri residents in the “bare counties” will now have an option, but there are still gaps elsewhere. There are 38 counties in Nevada, Indiana and Ohio that are at risk of not having any ACA exchanges options in 2018. Those counties have 25,133 enrollees in the exchanges plans, according to the Kaiser Family Foundation.
There is also the issue of many counties only having one choice. Avalere recently found that 41% of counties may only have one payer option in 2018. Less competition among payers is likely to increase costs for providers.
In addition to those counties, there is also still much uncertainty in the exchanges for 2018. The major reasons for the uncertainty are healthcare reform discussions on Capitol Hill and the White House and Congress not publicly backing cost-sharing reduction subsidies that insurers receive to cover lower income Americans in the exchanges. Without those subsidies, insurers say the market will collapse, or at the very least premiums will skyrocket.
Hefty premiums increases are expected in 2018. For the second straight year, the average rate increase is expected to reach 20%.