Anthem likely to leave ACA markets for 2018

Twitter icon
Facebook icon
LinkedIn icon
e-mail icon
Google icon
 - Anthem CEO Joseph Swedish

Financial analysts are predicting Anthem, one of the nation’s largest health insurers, will be following other national companies in leaving the Affordable Care Act (ACA)’s exchanges in 2018.

Anthem is “is leaning toward exiting a high percentage of the 144 rating regions in which it currently participates,” according to a research note from Jefferies analysts David Windley and David Styblo obtained by Bloomberg.

The insurer sold plans under the Blue Cross Blue Shield brand in 14 states for 2017. Anthem CEO Joseph Swedish had already threatened to scale back for 2018, and had notably been one of the few voices in healthcare to support President Donald Trump’s now-scrapped ACA replacement plan, the American Health Care Act (AHCA).

Without changes to stabilize the market, Swedish said Anthem would have to “significantly extract” itself from exchange participation after losing a total of $374 million on the individual market in 2016. The same Bloomberg report mentions, however, that Anthem expects to turn a “modest” profit on its exchange business this year.

No help from the Trump administration appears to be forthcoming, as the president himself has predicted the ACA will “explode” in the coming months. HHS Secretary Tom Price was noncommittal about taking planned regulatory actions at a congressional hearing on March 29, though he did vow to “uphold the law” of the ACA.

According to an analysis from Axios, an Anthem departure could affect up to 815,000 customers. Around 255,000 enrollees in Colorado, Kentucky, Missouri and Ohio would be at risk of having no available insurers on the exchanges, and the ACA doesn’t have a provision to guarantee coverage if no insurer elects to participate in some areas.

If Anthem follows through on the exit rumors, it would join several other major insurers who have left the ACA marketplace. UnitedHealth exited almost all markets for 2017, while Aetna and Humana planned to do the same next year after their proposed merger was blocked by the federal government in court.