Dive Brief:
- Oregon state officials are now supervising and limiting operations of Moda Health.
- Due to financial difficulties, the Portland-based company is now blocked from selling or renewing policies, and was given seven days to raise capital or face the possibility of further restrictions, KOIN reports.
- In addition, the state is working to help transition the approximately 67,000 Moda members who signed up during the just-concluded enrollment period to other payers through a special enrollment period.
Dive Insight:
The move comes after an apparent sudden change in Moda's outlook.
"We learned this week that their condition had deteriorated pretty significantly in the fourth quarter of 2015 and bringing them to the point where we felt that in order to protect consumers, we needed to step in and take some action," Lisa Morawski, communication director of the Oregon Department of Consumer and Business Services, told KTZV last Friday.
Moda spokesman Jonathan Nicholas released a statement that the insurer planned to exit the individual market for consumers who buy their own policies but are not on Medicare, KOIN reports, adding the events mark a "dramatic reversal for the once-dominant firm."
The company was reported to have taken a $90 million hit as a result of the federal government failing to come through with the level of protection previously planned for marketplace participants. Unlike other insurers, Moda had based its rates on the assumption that the full amount of funds would come through.