While Republicans in the Senate are getting ready to unveil their health reform bill, health insurers on the Obamacare exchanges have been revealing their plans for next year ahead of Wednesday’s deadline to file initial 2018 rate requests.
“We are spending 98 percent of our days thinking about ‘what does the product look like? What network can we build?’… and two percent worrying about the regulatory framework,” said Mario Schlosser, CEO of Oscar Health.
Oscar is planning on launching in two new states next year, announcing Wednesday morning that it will offer coverage in the greater Nashville area in Tennessee, in addition to its new joint venture to offer a plan with the Cleveland Clinic in northeast Ohio.
But Oscar’s expansion won’t extend to some of Ohio’s potentially bare counties, in the southeastern part of the state, where Anthem’s decision to withdraw from the state’s Obamacare exchange next year could leave some markets with no insurer coverage.
“We’ve really got to make sure that our unique strategy around how we build networks… also works,” said Schlosser.
Centene announced that it would be expanding coverage into both Ohio and Missouri, but a spokeswoman for the insurer said it is still working out which parts of those states it will cover.
As of Wednesday’s deadline, roughly two dozen counties in northwest Missouri have no insurers filing to provide 2018 coverage, according to an analysis by researchers at the Kaiser Family Foundation.
“It is entirely possible that Centene or other insurers could move into some counties that appear to be at risk of having no insurer,” said Cynthia Cox, associate director at Kaiser Family Foundation. “Consumers in these counties shouldn’t worry too much yet, as there is still time for insurers to change their service areas. Companies don’t get locked in until early fall.”
In Washington state, there were two counties facing no insurer coverage, but as of this week, an insurer stepped in to cover one of them.
“I really feel for a number of our insurance companies, because it’s not that they don’t want to be participating,” said Michael Marchand, chief marketing officer of the Washington Health Benefit Exchange. “It’s the uncertainty in the marketplace.”
Insurers in Washington State are asking for a 22 percent increase for next year, on average. States insurance officials say the carriers are trying to price in risk that they may not be reimbursed by the Trump administration for cost-sharing reduction subsidies that lower out-of-pocket costs for lower-income enrollees.
“As a result, we’re seeing an increase in premiums because it’s essentially the insurance companies hedging their bets that there may be the potential for them to have to pick up that CSR costs,” said Marchand.