Cen­tene ready to fill in­sur­ance gap in aban­doned Mis­souri mar­kets

Modern Healthcare - - REGIONAL NEWS - —Shelby Liv­ingston

Cen­tene Corp. will sell in­di­vid­ual health in­sur­ance ex­change plans in 40 Mis­souri coun­ties next year, in­clud­ing dozens of coun­ties that were at risk of hav­ing no mar­ket­place op­tions in 2018.

The St. Louis-based in­surer is one of a few health plans mov­ing into mar­kets that other in­sur­ers ditched be­cause of fi­nan­cial losses and on­go­ing reg­u­la­tory un­cer­tainty over health­care re­form.

The CMS un­der the Trump ad­min­is­tra­tion has held up re­cent mar­ket­place re­treats by in­sur­ers An­them and Aetna as a sign that Af­ford­able Care Act mar­ket­places have failed. The agency last month pro­jected 49 coun­ties will have no ex­change op­tions next year.

If no mar­ket­place health plan is avail­able, con­sumers wouldn’t have ac­cess to the fed­eral fi­nan­cial sub­si­dies that re­duce pre­mi­ums and lower outof-pocket costs.

But those gaps in cov­er­age are start­ing to be filled. Now 38 U.S. coun­ties in In­di­ana, Ohio and Ne­vada are at risk of hav­ing no mar­ket­place in­sur­ers, ac­cord­ing to the Kaiser Fam­ily Foun­da­tion, which tracks in­surer par­tic­i­pa­tion. In those “bare” coun­ties, 25,133 peo­ple are enrolled in ex­change cov­er­age.

Cen­tene, which serves 1.2 mil­lion mar­ket­place mem­bers, pre­vi­ously an­nounced it would start of­fer­ing cov­er­age on ex­changes in Kan­sas, Mis­souri and Ne­vada, while ex­pand­ing its foot­print in the six states where it cur­rently sells plans. It’s still un­clear which Ne­vada and Kan­sas coun­ties Cen­tene will en­ter.

Cen­tene is one of a few in­sur­ers that have man­aged to turn a profit on the ex­changes, thanks to its expe- rience man­ag­ing the care of low-in­come Med­i­caid mem­bers and its nar­row-net­work, low-premium plans.

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