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What Happens When Major Insurers Exit the Obamacare Marketplace?

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What Happens When Major Insurers Exit the Obamacare Marketplace?

Erica Block

Updated: March 14, 2019    Published: May 15, 2017

What Happens When All Major Insurers Exit the Obamacare Marketplace |
Image: Stuart Seeger / Flickr

If insurers Anthem, Centene, Cigna, and Molina all exit, it’ll leave 231 counties in the U.S. with no health insurance options on the Obamacare marketplace.

Since its implementation in 2013, the Affordable Care Act has helped more than 16 million Americans access healthcare coverage for the first time. Though the ACA has reduced the number of uninsured Americans by 35 percent, it also relies on health insurance companies volunteering to sell coverage through state marketplaces. In other words, there’s no contingency plan in place if no health insurer steps forward to offer coverage in certain states or geographical regions.

Aetna, Humana Pull Out of Obamacare Marketplace

Recently, a number of prominent insurers like Aetna and Wellmark announced they will not participate in Obamacare marketplaces in 2018. Their decision not to offer coverage through specific state exchanges puts certain geographical areas in the U.S. at risk of having no insurance plan options at all. Aetna’s plans to leave Delaware or Nebraska (in addition to their earlier decisions to leave Virginia and Iowa) effectively means that the company is pulling out of the Obamacare marketplace completely – with no options whatsoever on any state exchanges. Humana has also made a similar decision, with plans to completely exit the marketplace next year.

Sure, there are still plenty of major insurance companies that offer plans on exchanges. Last week, Kaiser Permanente CEO Bernard Tyson reaffirmed the company’s confidence in the exchanges. Blue Cross and Blue Shield also expressed some confidence, with BC and BS of Tennessee announcing that plans to sell health insurance plans on the ACA exchange in the parts of Tennessee affected by the loss of Humana. But what happens if/when other major insurance companies follow in the footsteps of Aetna and Humana?

Probable Future: Counties with No Insurance Options

To help readers understand the precarious state of ACA insurance marketplaces, two reporters at Vox teamed up with Kathy Hempstead at the Robert Wood Johnson Foundation to illustrate the effect of four major Obamacare plans leaving the network. In a worst-case scenario, if insurance companies Anthem, Centene, Cigna, and Molina exit all Obamacare exchanges, it’ll leave 231 counties in the U.S. with no health insurance options on the Obamacare marketplace whatsoever. This is all currently unlikely, as companies like Centene and Molina have actually turned profits under ACA, but it’s still very much a possibility.

Check out Vox‘s interactive visualization to see what insurance availability will look like in different states if Anthem, Molina, Centene, and Cigna pull out of local marketplaces.

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(H/T Vox)

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