Anthem, MDwise to exit Indiana’s Affordable Care Act marketplace in 2018

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INDIANAPOLIS, Ind– Anthem Blue Cross and Blue Shield says it is pulling out of the Affordable Care Act (ACA) marketplace for 2018 and reducing the number of plans offered in Indiana counties to a single, off-exchange plan.

MDwise also elected to not participate in the heath exchange starting in 2018.

The companies join a list of major insurers who have already left the marketplace, including UnitedHealthCare, Humana and Aetna. Anthem has also left the marketplaces in Ohio and Wisconsin.

MDwise said the decision was influenced by “the growing uncertainty over the future of the federally subsidized exchange.” The company also said it lost $21 million in 2016 alone on its health insurance exchange business.

MDwise will focus on its larger Medicaid plans that cover 370,000 members in all 92 Indiana counties enrolled through two state programs, Hoosier Healthwise and the Healthy Indiana Plan. Care is delivered to MDwise’s Medicaid members through partnerships with eight leading healthcare delivery systems.

Anthem also said their decision was made due to a “volatile” market:

“A stable insurance market is dependent on products that create value for consumers through the broad spreading of risk and a known set of conditions upon which rates can be developed.  We are pleased that some steps have been taken to address the long term challenges all health plans serving the individual market are facing, such as improving the eligibility requirements that allow consumers to purchase a plan outside of open enrollment and improved risk adjustment. However, the Individual market remains volatile, making planning and pricing for ACA-compliant health plans increasingly difficult due to a shrinking and deteriorating market as well as continual changes and uncertainty in federal operations, rules and guidance, including cost sharing reduction subsidies and the restoration of taxes on fully insured coverage.”

The off-exchange medical plan from Anthem will be available in Benton, Newton, White, Jasper and Warren counties.

Anthem  says their decision doesn’t impact the vast majority of the 4 million Anthem Blue Cross/Blue Shield members. Those who have employer-provided insurance, Medicare Advantage, Medicare Supplement, Medicaid or those enrolled in plans purchased before March 2010.

Affordable Care Act plans purchased this year from Anthem will remain in effect until Dec. 31.

Anthem says as the marketplaces continues to evolve, they will continue to partner with the State of Indiana to advocate for solutions.

Governor Eric Holcomb issued the following statement regarding Anthem and MDwise’s decision:

“We’ve been informed that Anthem and MDwise plan to leave the Obamacare marketplace in Indiana. Hoosiers served by these providers under the federal marketplace will keep their coverage through the end of the year, and this action does not apply to those who are insured through their employers or are members of HIP 2.0, Medicaid or Medicare.”

“We’ll know the full extent of the issues with the Obamacare marketplace tomorrow when all provider rates are published, but this is more evidence that the current federal system isn’t working. Indiana is one of many states where Obamacare is failing to provide citizens options to affordable, quality healthcare.”

“This underscores the need for reform, and Indiana is poised to lead the way if given the flexibility and time to tailor the best solutions.”

The Republican National Committee (RNC) issued this statement:

“This decision is yet another example of the devastating effects of Obamacare’s failings,” said Chairwoman McDaniel. “Insurers are rapidly exiting the marketplace, leaving Americans with little to no choice, skyrocketing premiums, and rising costs. We have to act quickly to fix the mess of Obamacare. President Trump and Republicans in Congress have put forward a plan that will offer the American people the quality and affordable healthcare system they deserve. It’s time for Senate Democrats to drop their obstructionist tactics and join Republicans in the effort to fix our broken healthcare system.”

The Democratic Senatorial Campaign Committee issued this statement:

“Today’s decision by Anthem and MDwise to pull out of Indiana’s individual insurance market is devastating news for Hoosiers across the state. Congressmen Messer and Rokita are actively sabotaging their constituents’ health care by creating uncertainty in the marketplace and supporting a toxic health care plan: decimating HIP 2.0 –  hailed as ‘one of the biggest success stories in Indiana health care,’ – leaving more than 310,000 Hoosiers without care, and causing premiums to rise by $2,455 a year. Hoosiers will know who’s to blame when they no longer have access to affordable care and we will hold them accountable.”

Rep. Luke Messer (R-IN 06) had this to say on the matter:

“Today’s announcements confirm what most Hoosiers already knew: Obamacare is broken beyond repair. Now, tens of thousands of Hoosiers will be left with few options on the exchange, and some counties may be left with no options at all. Despite the rhetoric of Obamacare’s supporters, we must act now to repeal this failed law and rescue Indiana’s consumers. I urge my colleagues in the Senate to quickly send legislation back to the House so that we can finally provide relief.”

Sen. Joe Donnelly (D-IN) said:

“Today’s decision is especially disappointing because tens of thousands of Hoosiers are losing their coverage, an outcome forced by this Administration’s deliberate strategy to create chaos and undermine the health care coverage of Hoosiers. We should all be able to agree that we want to protect access to affordable health care, and it is now more important than ever that the Senate work together in a bipartisan way to ensure Hoosiers have access to affordable quality coverage.”

Rep. Andre Carson (D-IN 07) issued this statement:

“With so many families reliant on the health care exchange across our state, I am extremely disappointed in the decision by several insurers to pull out of Indiana’s Exchange. This decision means Hoosiers now have fewer options to choose from on the health Exchange. Despite my disappointment, I am not surprised by today’s announcement. Insurers, like any other business, need to know what the market will look like when determining how best to provide viable, valuable, and marketable insurance. Unfortunately, the potential passage of the American Health Care Act, as well as the Trump Administration’s repeated actions to undermine the marketplace, has created more uncertainty and instability.

“I urge the Administration and Republicans in Congress to stop undermining the markets, holding Hoosiers’ healthcare hostage. Instead, they should be working to improve, not repeal, the Affordable Care Act. Since the ACA’s passage in 2010, Indiana’s uninsured rate has fallen by 35 percent, translating into 339,000 Hoosiers gaining coverage.

“Passage of the American Health Act would kick 23 million Americans off coverage, allow discrimination against Americans with pre-existing conditions, eliminate coverage for essential benefits in many parts of the county, and further destabilize the insurance market. Unfortunately, today’s announcement demonstrates that thousands of Hoosiers are already being hurt by the actions of Republicans in Congress and the Administration.”

Karen Brooks (R-IN 05) issued this statement:

“In 2016, Hoosiers who bought their insurance on the exchange had eight health insurance carriers to choose from and half of those carriers made the decision last year to no longer participate in the exchange in 2017. Today’s news again confirms the sad reality that our country’s healthcare system is in desperate need of repair as today only two insurance carriers remain to offer healthcare coverage on the Indiana exchange in 2018, stripping 77,000 Hoosiers of their preferred healthcare coverage and doctors. I am particularly concerned about my constituents in Grant County who will be left without an option for coverage on the exchange, as well as those living in Blackford and Tipton counties who will have just one option for health insurance on the exchange in 2018. This reality is why I have prioritized rebuilding our broken healthcare system from the beginning and will continue to work with my colleagues in Congress on a solution that supports Hoosiers and their families.”

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