Anthem pulls out of Ohio: What’s really going on?

Anthem Blue Cross and Blue Shield will pull out of Ohio’s Health Insurance Marketplace at the end of this year, following in the footsteps of competitor, Aetna, which pulled out of the federal health insurance exchange created by the Affordable Care Act (ACA) earlier this year.

Here’s what you need to know:

HOW MANY PEOPLE ARE IMPACTED?

Anthem announced its decision to exit the marketplace Tuesday, affecting about 44,000 exchange members in Ohio, according to figures provided by the Ohio Department of Insurance (ODI). Anthem said it will continue to offer an off-exchange individual health insurance plan in Ohio in Pike County next year, but the company’s exit from the marketplace means residents of at least 18 Ohio counties will have no options on the state exchange next year unless another health insurer steps in to fill the void.

WHY DID ANTHEM PULL OUT?

Anthem, which said its decision to drop out of the state exchange does not impact individuals or families with grandfathered plans, pointed to the uncertainty surrounding President Donald Trump’s-endorsed GOP plan to replace the ACA, commonly referred to as Obamacare, as the impetus for the move.

COULD ANTHEM RETURN TO OHIO’S INSURANCE EXCHANGE?

Anthem reserved the right to return to Ohio’s insurance exchange at a later date: “As the Individual marketplace continues to evolve, Anthem will continue to advocate solutions that will stabilize the market to allow us to return to a more robust presence in the future.”

HOW MANY INSURERS ARE LEFT IN OHIO?

Insurance companies had to propose their 2018 rates in Ohio by Monday under the Affordable Care Act. Approximately 11 insurers filed rates for the upcoming coverage year by 5 p.m. on Monday — the same number as last year, but six fewer than in 2016. Insurers and rates have not been announced yet.

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