Insurers shunning Mississippi poor

Tough start for Obamacare in the Delta

Tens of thousands of uninsured residents in Mississippi may be unable to get subsidies to buy health coverage when a new online marketplace opens this fall because private insurers are avoiding a wide swath of the state.

No insurer is offering plans through the federal health law’s marketplace in 36 of the state’s 82 counties, including some of the poorest parts of the Delta region, said Mississippi Insurance Commissioner Mike Chaney.

As a result, 54,000 people who may qualify for subsidized coverage would be unable to get it, estimates the Center for Mississippi Health Policy, a nonpartisan research group. Many earn too little to buy coverage on their own.

“That’s the place where it’s most needed,” said Roy Mitchell, executive director of the Mississippi Health Advocacy Program. “There’s a high uninsured population there. One of the highest infant mortality rates in the country is in that area. A real lack of preventive care.”

One of the goals of the health law put forward by President Barack Obama and passed by Democrats in Congress was to provide coverage to people who cannot afford coverage today. The gaps in Mississippi could undermine that promise.

There is still some time: The federal government has extended a deadline and allowed Mississippi to grant insurers several more weeks to file applications to sell coverage, Chaney said. The marketplaces open for enrollment Oct. 1 for individuals and small businesses.

Insurers declined to comment on the reasons they chose not to offer plans in those counties. But Chaney and others said concerns include the difficulty of creating networks of doctors and hospitals in rural areas, the poverty of the region and uncertainty about the health law.

Insurers “have a tendency not to want to come to a poor state and the poorest part of a poor state,” said Stansel Harvey, chief executive of Delta Regional Medical Center in Greenville, Miss.

Mississippi’s marketplace will be overseen by the federal government, after disagreement be- tween Chaney and Republican Gov. Phil Bryant, who opposed Chaney’s plan to create a state-run online market. Nationwide, 17 states will run their own markets; the rest are operating marketplaces in conjunction with the federal government or have defaulted to federal control.

I nsurers Humana and Centene’s Magnolia Health Plan will offer coverage in more than half of the state’s counties when the marketplace opens, according to data from Chaney. But they aren’t offering plans in the other counties because they don’t have the needed networks of doctors and hospitals, Chaney said. He added that “uncertainty about the law” led BlueCross BlueShield of Mississippi, which currently sells in all parts of the state, not to seek approval for plans in the new marketplace.