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Anthem Still Weighing 2018 Obamacare Individual Participation

Caroline Humer  |  May 24, 2017

NEW YORK (Reuters)—Anthem Inc on Wednesday said its plans for selling 2018 Obamacare individual plans are still up in the air because of political and regulatory uncertainty, making it the latest health insurer to say questions about continued funding of government subsidies will affect consumers next year.

Anthem, the biggest provider of individual health plans, is looking at all 14 states where it sells Obamacare coverage to determine to what extent it will participate next year, given the continued uncertainty around subsidies and regulations, its chief executive said on Wednesday.

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CEO Joseph Swedish, speaking at the UBS Global Healthcare Conference, said the No. 2 health insurer is talking to regulators in each of the 14 states where it sells BlueCross BlueShield plans about total or partial participation or “surgically extracting” itself from the market.

Republican lawmakers are trying to repeal and replace the Affordable Care Act, often called Obamacare, but have not agreed on how or on a transition plan for the income-based subsidized individual plans created under the law.

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Rival insurers Aetna Inc and Humana Inc have said they will not sell Obamacare plans next year. Anthem is assessing the ramifications of selling individual plans in later years if it withdraws, Swedish said. It has 1.1 million members in exchange-based plans and another 500,000 in similar plans sold through brokers and other third parties.

“We would prefer not to extract ourselves if we can get the math to work,” Swedish said.

Some states require insurers to sell subsidized plans on the exchanges created under Obamacare in order to sell non-subsidized plans elsewhere. Others bar insurers that leave the exchanges from re-entering for a number of years.

The window has nearly closed for the government to remove uncertainty about paying the cost-sharing subsidies created under Obamacare.

Republican lawmakers fought the Obama administration in court to nullify the subsidies and won. The case has been at a standstill while an appeal is heard, and earlier this week Republicans put the case on hold for another three months.

Swedish said a report coming later on Wednesday from the Congressional Budget Office that will lay out how proposed U.S. House of Representatives legislation would affect the budget and insurance coverage will guide how the U.S. Senate proceeds on its own healthcare bill.

“I think we are going to end up with a repair more than a repeal and replace once the Senate gets their arms around it,” Swedish said.

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Filed under:Practice SupportProfessional Topics Tagged with:Anthem Inc.

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