Insurers Anthem, MDwise Leaving Indiana Exchange

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INDIANAPOLIS -

The Indiana health insurance marketplace will have two fewer providers next year. Indianapolis-based Anthem Inc. (NYSE: ANTM) and MDwise Marketplace, also in Indianapolis, announced they will not be offering individual plans in Indiana through the federally-subsidized Affordable Care Act exchanges next year.

In a statement, Anthem cited instability in the individual market "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." It says Anthem Blue Cross and Blue Shield individual plans will only be offered in Indiana to one off-exchange medical plan in Benton, Newton, White, Jasper and Warren counties. Policy-holders with employer-provided plans, Medicare Advantage, Medicare Supplement, Medicaid or those who purchased plans before March 2010 will not be affected.

MDwise Marketplace's reasoning is similar and it says it lost $21 million on its health insurance exchange business last year. It has 30,800 members in Indiana covered by individual policies through the "Obamacare" system. MDwise, which entered Indiana's ACA marketplace in 2014, says it plans to focus on its growing Medicaid managed care business instead.

Wednesday's announcements come a year after Indiana University Health subsidiary Indiana University Health Plans also decided to leave Indiana's ACA marketplace.

Read Anthem's Full Statement:

For more than seven decades, Anthem Blue Cross and Blue Shield has served consumers in the Individual market. Throughout that time our commitment has remained the same: to provide access to affordable, quality healthcare. Since the inception of the exchange, we’ve proudly served consumers with fully insured individual health plans.

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.

As a result, Anthem Blue Cross and Blue Shield has made the difficult decision to  reduce its 2018 Individual plan offering in Indiana to one off-exchange medical plan in Benton, Newton, White, Jasper and Warren counties. This decision does not affect the vast majority of the 4 million members Anthem Blue Cross and Blue Shield serves in Indiana. It does not affect those who have employer-provided insurance, those with Medicare Advantage, Medicare Supplement, Medicaid or those enrolled in “grandfathered” plans (plans purchased before March 2010).

Anthem Blue Cross and Blue Shield recognizes the State of Indiana and its dedication to provide a stable regulatory environment.  As the Individual marketplace continues to evolve, Anthem Blue Cross and Blue Shield will continue partnering.

Read MDwise Marketplace's Full Statement:

MDwise Marketplace announced today that it will not participate on Indiana’s Health Insurance Exchange in 2018 to focus on its growing Medicaid managed care business.

When MDwise entered the Marketplace Exchange in 2014, it did so to provide continuity to its Medicaid members who no longer qualify for Medicaid and are looking to purchase coverage on the Marketplace Exchange.  Fewer members than expected have lost their Medicaid coverage and entered the Marketplace Exchange market.

MDwise’s decision to leave the Health Insurance Exchange was also influenced by the growing uncertainty over the future of the federally subsidized exchange. In 2016 alone, MDwise lost $21 million on its Health Insurance Exchange business.

The 30,800 members throughout Indiana who are covered by MDwise through the Health Insurance Exchange in Indiana are being notified of the decision to withdraw.

MDwise intends to 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.

MDwise has a continuous 23-year history as a provider of Medicaid managed care plans in Indiana.

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