Anthem Pulling Back on Offering ACA Plans in Nevada

By Anna Wilde Mathews Features Dow Jones Newswires

Anthem Inc. said it would stop selling Affordable Care Act marketplace plans in most of Nevada next year, leaving 14 counties in the state poised to have no insurer selling plans on its exchange.

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The state exchange agency, the Silver State Health Insurance Exchange, said that insurers had filed to offer plans in only three Nevada counties: Clark, Washoe and Nye, leaving the remaining, largely rural counties without any exchange options for 2018. Nevada's Republican governor, Brian Sandoval, said "lack of coverage in rural Nevada will set back years of work to reduce the uninsured rate throughout our state, " affecting around 8,000 people, and his office was trying to find a solution to help ACA enrollees in the those counties.

Anthem's pullback in Nevada follows announcements that it will completely exit the ACA marketplaces in Ohio, Wisconsin and Indiana.

The 14 Nevada counties join an estimated 47 counties in Ohio, Indiana and Missouri that currently appear at risk of having no exchange insurers in 2018, according to the Kaiser Family Foundation, after withdrawal announcements made by insurers. Still, the situation remains fluid, since other insurers may come in to fill the gaps, as has happened in Tennessee and Washington state.

Anthem's latest announcement comes as Senate Republicans are trying to push forward a health overhaul, and insurer exits and rate-increase proposals have become flashpoints in the debate over the bill. Republicans point to them as backing the need for their legislation, while Democrats say the insurers are reacting to the uncertainty created by Republicans -- including questions about the future of key federal payments to insurers that the Trump administration has threatened to stop.

Nevada's situation may draw more of the spotlight because its Republican Sen. Dean Heller has said he opposes the Senate bill, which is now being reworked.

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Echoing comments it previously made around other withdrawals, Anthem said its Nevada decision came as the "individual market remains volatile." The company said that "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." Anthem also said it was "pleased that some steps have been taken to address the long-term challenges all health plans serving the Individual market are facing."

The insurer is a major presence in its 14 state exchanges, with nearly 1.6 million people enrolled in its ACA plans, 1.1 million of those bought through the marketplaces. Overall, 302 counties in states including Georgia, Missouri and Ohio currently have only Anthem plans available in their marketplaces, according to the Kaiser foundation. So far, the insurer has filed 2018 ACA plans with regulators in other states, including Virginia, Maine and Connecticut. Anthem has said it is evaluating its ACA plans on a state-by-state basis.

Write to Anna Wilde Mathews at anna.mathews@wsj.com

(END) Dow Jones Newswires

June 28, 2017 18:34 ET (22:34 GMT)