Anthem withdraws from Indiana healthcare exchange

Anthem Blue Cross announced that it is pulling out of the ObamaCare insurance exchange in Indiana, beginning in 2018. The company, which is headquartered in Indianapolis, cites the volatile and shrinking health insurance market place as the reason.

Right after Anthem’s announcement, MDwise Marketplace announced it was leaving to focus on Medicaid-managed business.

Only CareSource, and Celtic (MHS) will be left in the exchange for next year.

“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,” read a news release from Anthem.

“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,” said Anthem.

That essentially means those five counties will be able to get a similar plan to the one that is currently offered under the exchange.

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).

MDwise said in a news release it can no longer fulfill its mission within the exchange.

“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,” said the company in a news release.

“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.