UPDATE: Anthem’s departure from Ohio to impact thousands


breaking news

CareSource construction site on fire in downtown Dayton 

UPDATE: Anthem’s departure from Ohio to impact thousands

Thousands of Ohio residents could be left scrambling for new insurance after Anthem Blue Cross and Blue Shield’s decision to pull out of Ohio’s Health Insurance Marketplace at the end of this year.

Anthem’s decision comes just months after its competitor, Aetna, pulled out of the federal health insurance exchange created by the Affordable Care Act (ACA) earlier this year. Indianapolis-based Anthem announced its decision to exit the marketplace on Tuesday, impacting about 44,000 exchange members in Ohio, according to figures provided by the Ohio Department of Insurance (ODI).

The departures of the two large insurers in Ohio follows a trend of dwindling numbers of insurance companies offering coverage in the state. In 2016, 17 companies sold health insurance products during open enrollment on the federal exchange in Ohio. This year, it dropped to 11.

“In terms of carriers leaving the individual market in Ohio, this has been a concern for the department in recent years,” said ODI spokesman Chris Brock. “As long as there is instability in the private insurance market because of uncertainty around the ACA, reduced participation by carriers will be a concern.”

» ANTHEM PULLS OUT OF OHIO: What’s really going on?

The number of carriers is likely to hold steady in 2018, with 11 insurers filing rates for the upcoming coverage year by the deadline on Monday evening. Currently, 20 of Ohio’s 88 counties have a single insurer selling on the federal insurance exchange, and 27 have two insurers.

Those 11 insurers have not been identified, according to the Department of Insurance.

Because of Ohio law, only the companies filing as Preferred Provider Organizations (PPOs) can be disclosed right now. Both SummaCare and Aultcare have filed as PPOs for the 2018 coverage year. The companies filing as Health Insuring Corporations (HICs) are confidential until their filings are approved — which is typically sometime in August.

Anthem said it will continue to offer an off-exchange individual health insurance plan in Ohio in Pike County next year, but the company’s exit from the marketplace means residents of at least 18 Ohio counties will have no options on the state exchange next year unless another health insurer steps in to fill the void.

Those 18 counties include: Coshocton, Crawford, Guernsey, Hancock, Harrison, Hocking, Holmes, Jackson, Knox, Lawrence, Morgan, Muskingum, Noble, Paulding, Perry, Van Wert, Vinton and Wtandot. The counties would be affected starting Jan. 1, 2018.

“For the past few years we have seen a weakening in the federal insurance marketplace as a number of companies have withdrawn from the exchange,” Brock said. “We have always argued the private insurance market is the most severely impacted by the federal law and that is where Congressional action is needed to restore stability. The Department of Insurance is looking for options to help the approximately 10,500 Ohioans in counties where there may not be an exchange plan when this takes effect in 2018.”

Anthem said its decision to drop out of the state exchange does not impact individuals or families with grandfathered plans. Company officials said the uncertainty surrounding the GOP plan endorsed by President Donald Trump to replace the ACA influenced the decision to depart from the state.

“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,” company officials said in a written statement. “Today, planning and pricing for ACA-compliant health plans has become increasingly difficult due to the shrinking individual market as well as continual changes in federal operations, rules and guidance.”

The company’s decision has elicited reactions from politicians — both parties blaming failed policies on each other. Ohio Democratic Party Chairman David Pepper said the “Trump administration’s policies are directly responsible for the mess Ohio families now face.”

Ohio Republican Party Chairman Jane Timken blamed the Affordable Care Act for the company’s decision to pull out of Ohio: “It’s clear that Obamacare has failed, but Democrats like Sherrod Brown continue to deny reality.”

Insurers are exiting markets across the country, and some companies like Aetna, Blue Cross and Blue Shield and Humana are leaving the on-exchange market completely.


17: Companies that sold health insurance products during open enrollment on the federal exchange in Ohio in 2016.

11: Companies that will sell health insurance products on the exchange in Ohio in 2017.

88: Counties in Ohio that had at least four insurers selling exchange products during open enrollment in 2016.

20: Counties that will only have one insurer selling on the federal exchange in 2017.

27: Counties that will have just two insurers selling on the federal exchange in 2017.

View Comments 0

Weather and Traffic