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More Payer Options to be Available in 2019 ACA Marketplaces

November 16, 2018

According to a new report from the Kaiser Family Foundation (KFF), the Affordable Care Act (ACA) exchanges are expected to have more competition in 2019.

Compared to previous years where major payers have dropped out of the exchanges, the report from KFF estimates that there will be an average of four payers per state that will participate in 2019.

According to the report, in 2014 the state average was five, however this did include only one option in New Hampshire and West Virginia and 16 options in New York. In 2015 the average increased to six per state before falling to 5.6 in 2016 and 4.3 in 2017 due to losses and market instability. Further, the report found that the average dropped to 3.5 in 2018.

Although there were concerns in 2018, payers are now seeing profits, and it is expected that payers including Centene, Cigna, Oscar Health, Anthem, and Wellmark will either be join the 2019 market or will be expanding into more counties.

The report found that more than half of enrollees will have a choice of at least three payers in 2019. However, three states will have more than 10 payers and five states will only have one option.

Payers are still expected to practice silver loading, which allows insurance companies to move costs associated with losing cost-sharing reduction payments to silver plans.

Despite more payer options for 2019, it appears that there has been little interest in open enrollment. CMS recently reported that only 371,676 people selected plans on during the first few days of open enrollment, and during the second week CMS reported numbers of more than 800,000 people. They noted that of the 1.2 million people that have signed up, more than 270,000 are new enrollees.

Julie Gould

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