Centene to fill Missouri insurance void left by Blue Cross

Health insurer Centene Corp. said Friday that the nearly 40 Missouri counties where it will launch coverage on Affordable Care Act insurance exchanges next year include roughly two dozen that would otherwise have been without an insurer.

Missouri-based Centene Corp.'s announcement Friday came 17 days after it said it would foray into the Missouri exchanges even as others are either withdrawing from such markets or proposing steep price hikes to remain. Consumer rights advocates celebrated the announcement, saying something is better than nothing.

Centene's planned offerings in 39 counties and the city of St. Louis will fill an expected void tied to Blue Cross and Blue Shield of Kansas City's pledged pullout of that individual insurance marketplace next year — an exodus that would have left 25 Missouri counties with no insurance provider under the exchanges.

"We strive to be a responsible partner with the state and are committed to working closely with regulators and policymakers to collaborate on actions that stabilize the market and offer affordable coverage options," Michael Neidorff, Centene's chairman, president and chief executive, said in a statement.

Separately, Missouri Insurance Director Chlora Lindley-Myers called Friday's announcement "extremely positive news for all Missourians." She cautioned that final decisions regarding exchange participation by insurers for next year and service areas likely won't be final until late September, when insurance companies sign contracts with the federal marketplace.

Centene covers 1.2 million customers through the exchanges and is among that market's biggest providers of health insurance.

That insurer's growth spurt could fill some big holes that have developed in the exchanges, the only place where people can buy individual coverage with help from an income-based tax credit. Currently, 25 counties in Missouri, 20 in Ohio and another two in Washington have no insurers lined up to sell coverage on the exchange in 2018.

Cara Spencer, executive director of the Consumers Council of Missouri advocacy group, cheered Centene on Friday "for stepping up and filling in where no one else is operating," demonstrating the Missouri market's viability despite Blue Cross and Blue Shield's pledged departure.

"It's a great day for Missouri health-care consumers," she said. "Ideally, our health insurance consumers would like to have a choice, and it's disappointing they only have one (in many counties). But at least we have an option."

Big national insurers such as Humana and Aetna have shuttered their exchange businesses for next year. President Donald Trump's administration has highlighted the thinning options that remain in many markets as congressional Republicans devise a potential replacement for the Affordable Care Act.

Many insurers have been hit with steep losses by their exchange business since it started in 2014. But they've also been pulling back from this market or raising prices because of the uncertain future of billions of dollars in government funding that helps reduce some coverage expenses for people with modest incomes. Trump has talked about potentially stopping the payments, and insurers want a guarantee that they will last through next year.

Centene does well on the exchanges because it sticks to customers it knows, analysts have said. The insurer specializes in managing the state and federally funded Medicaid program for the poor.

On the exchanges, it markets to low-income customers in areas where it has already formed networks of providers for its Medicaid business. Centene said 90 percent of its customers are eligible for subsidies, and most of its customers this year were renewals from 2016, which makes it easier to figure out prices.

Missouri counties that beginning next year will be covered by Centene next year in the exchanges are Andrew, Atchison, Barry, Bates, Benton, Buchanan, Caldwell, Carroll, Cass, Christian, Clay, Clinton, Daviess, DeKalb, Franklin, Gentry, Greene, Grundy, Harrison, Henry, Holt, Jackson, Jasper, Jefferson, Johnson, Lafayette, Lawrence, Livingston, Mercer, Newton, Nodaway, Pettis, Platte, Saline, St. Charles, St. Clair, St. Louis, Vernon and Worth. The city of St. Louis also will be served.