Anthem pulls out from healthcare exchange in Virginia in 2018

Anthem pulls out from healthcare exchange in Virginia in 2018

(WWBT) - Anthem Blue Cross and Blue Shield said on Friday that it will be scaling back on individual coverage in Virginia in 2018. This will only affect plans on the individual exchange under the Affordable Care Act (ACA).

Anthem said it will reduce the 2018 individual plan offering and only offer off-exchange plans in Washington and Scott counties, and the city of Bristol.

In a statement, the company said the reason for the pullout is due to "planning and pricing for ACA-compliant health plans has become increasingly difficult due to a shrinking and deteriorating individual 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."

Anthem has already scaled back on healthcare marketplace offerings in Indiana, Ohio, and Wisconsin due to an unstable individual market for plans operating under the ACA.

Aetna pulled out saying it lost $160 million from the exchanges last year and expects to lose $200 million this year.

United Health Group pulled out citing similar reasons.

In July, Senate Republicans failed to repeal Obamacare several times. They did not have enough votes to do so.

Virginia Governor Terry McAuliffe released the following statement:

Anthem leadership informed me this afternoon about its decision to leave the federal insurance exchange in Virginia, citing the President's threats to cut off cost-sharing reduction payments to insurers and his deliberate efforts to dismantle the individual insurance market. It's unfortunate Anthem felt it could no longer participate in the exchange because of the uncertainty created by the President and Congress. Today's decision will result in more than 200,000 Virginians losing their quality, affordable coverage through Anthem, representing approximately half of the Virginians who purchase insurance on the exchange.

Virginia Lieutenant Governor Ralph Northam released a statement:

This is a direct consequence of Donald Trump's deliberate effort to destabilize and sabotage the Affordable Care Act (ACA) — efforts Ed Gillespie has consistently supported. If anything, this now makes it clear that Ed would be nothing more than Donald Trump's top lobbyist in Virginia advocating for the same disastrous policies without regard to how they hurt Virginians.

Virginia House of Delegates Speaker William J. Howell (R-Stafford) released a statement:

Today's announcement from Anthem is further proof that the markets are collapsing and Obamacare is broken. Anthem now joins two other major insurers exiting the Virginia marketplace for 2018: Aetna and UnitedHealthcare. This will leave fewer than 5 insurers offering health insurance to Virginians, most of whom will now only get one choice for insurance. This is on top of already double digit premium increases for 2018.
 
"Obamacare needs to be repealed and replaced, that much is clear. Obamacare is hurting more people than it is helping, forcing Americans to buy insurance they don't like, don't need, and cannot afford. Now is the time for Congress to come together and figure out a solution that gives much needed relief to hardworking families. If Congress continues to kick the can down the road, it will only exacerbate the problems we currently face.

U.S. senators Mark Warner and Tim Kaine released a statement:

As a result of the uncertainty, mixed signals and deliberate sabotage from the Trump Administration, some insurers will raise premiums and scale back their health insurance offerings in the individual market, which serves more than 400,000 people in Virginia. It is unfortunate that others, such as Anthem, are choosing to leave the marketplace altogether.

Here's the full statement from Anthem:

After significant dialogue with federal leaders and regulators, Anthem Blue Cross and Blue Shield has made the difficult decision to revise our filings for our 2018 Individual plan offerings in Virginia.

While we are pleased that some steps have been taken to address the long term challenges all health plans serving the Individual market are facing, the Individual market remains volatile. 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. Today, planning and pricing for ACA-compliant health plans has become increasingly difficult due to a shrinking and deteriorating individual 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.

Specifically, Anthem will not participate on the Individual Exchange in Virginia for 2018. Additionally, Anthem will reduce its 2018 Individual plan offering and will only offer off-exchange plans in Washington and Scott Counties, and in the City of Bristol, VA. It’s important to note, this decision does not affect those who have employer-based insurance or individuals enrolled in “grandfathered” plans (plans purchased before March 2010), or those enrolled in Medicaid or Medicare plans.

Our commitment to members has always been to provide greater access to affordable, quality healthcare, and we will continue to advocate solutions that will stabilize the market and allow us to return to a more robust presence in Virginia in the future. 

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