Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Private Payers News

Anthem to Withdraw from ACA Individual Market Exchanges in NV

Anthem will cease the sale of individual health plans as part of the Nevada exchange.

Anthem will cease the sale of individual health plans as part of the Nevada exchange.

Source: Thinkstock

By Thomas Beaton

- Anthem BlueCross BlueShield (BCBS) will completely withdraw from Nevada’s ACA exchange for individual health plans in 2018, the health payer announced on Monday.

The payer’s decision follows discussion with state leaders and regulators. Anthem decided to halt the sale of ACA-compliant silver plans and choose only to sell catastrophic-grade plans (health plans only available to consumers under the age of 30 with low incomes).

Anthem said the decision is the result of financial hardship when attempting to participate in the individual ACA marketplace.

“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,” the company stated.

“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,” the statement continued. “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.

The head of the state’s insurance commission issued a statement as well, noting that the state will take the necessary steps to bring in a new insurance carrier. Anthem’s exit follows the payer’s previous 14-county exit out of the exchanges, leaving many counties without an exchange option.

“While the [Nevada Insurance] Division is disappointed in Anthem’s latest decision regarding its withdrawals, we believed that it was in the interest of the Nevada public to let consumers know about the Anthem decision as soon as possible” said Commissioner Barbara Richardson. “The Division is continuing to work with our state partners on attracting an insurance carrier to serve the 14 bare counties and to support the stability of the market for those insurance carriers who remain.”

“We are also working with our state partners on a plan to help consumers shop the Exchange market at open enrollment for the 2018 Plan Year and remain optimistic that there will be coverage for consumers on the Exchange throughout the state,” she continued.

Other large payers — Aetna, state divisions of BCBS, Humana, and Wellmark BCBS — also exited ACA individual plan exchanges across the country. These payers cited large financial losses and shrinking markets as the reason for exiting state and county-level exchanges.

Payers that exited the exchanges may be able to mitigate losses, but may inadvertently reduce care quality for customers. A survey from Black Book found that ACA insurance consumers are reporting lower satisfaction as a result from lower market competition in service, quality, and affordability.

“The downward slide in competition means that in 2017, consumers in 70 percent of US counties are left with just one or two insurer options on the exchanges, up from 36 percent in 2016,” the study reads.

Anthem concluded their announcement with a commitment to help stabilize the Nevada insurance market, allowing the payer to have a greater state healthcare impact in the future.

“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 Nevada in the future,” the company said.


Sign up for our free newsletter:

Our privacy policy

no, thanks

Continue to site...