Anthem’s Exit Creates Obamacare ‘Crisis’ for Rural Nevadans

Updated on
  • Once an ACA stalwart, insurer is now reducing plans for 2018
  • Nevada governor, senator major voices in health bill debate

Why Insurers Are Quitting Obamacare

Anthem Inc.’s decision to quit offering Obamacare plans in much of Nevada will leave large parts of the state without options on the health law’s exchanges.

The health insurer, a one-time Obamacare stalwart, has accelerated its retreat in recent weeks, blaming in part the uncertainty about the fate of the health law in Washington for making it difficult to come up with plans and calculate premiums.

In Nevada, officials including Republican governor Brian Sandoval called the situation a crisis Wednesday night. Anthem will now offer plans on the Affordable Care Act’s exchange in just three of the state’s more-populated counties, after previously selling coverage statewide. That leaves about 8,000 people in 13 counties and Carson City without access to Obamacare health plans and the government subsidies that often come with them, according to the state’s Silver State Health Insurance Exchange.

“I consider this a health-care crisis for rural Nevada,” Heather Korbulic, executive director for the exchange, said in a statement. “My staff and I are doing everything within our control and influence to secure resources for consumers.”

Major Role

Sandoval and Nevada GOP Senator Dean Heller are playing a major role in the debate over the future of Affordable Care Act, both opposing the embattled Senate health bill that is now on hold until after the July 4 recess. Republicans in Congress are struggling to agree on a way to fulfill their campaign promise to undo Obamacare, which contributed to the deterioration of the individual market. And Heller was one of the key senators whose opposition forced Senate Majority Leader Mitch McConnell to delay a planned vote on the bill this week.

Under the ACA, Nevada was among 31 states that broadened eligibility for their Medicaid programs to more low-income people. Sandoval said Wednesday that the Medicaid expansion and subsidized health plans helped to dramatically reduce uninsured rates, and that his administration is working to craft a safety net for individuals in the empty counties.

“Lack of coverage in rural Nevada will set back years of work to reduce the uninsured rate throughout our state,” he said in the state exchange’s statement. “I have communicated the news of this crisis to U.S. Health and Human Services Secretary Tom Price.”

‘Increasingly Difficult’

Anthem still has a larger presence in the ACA than major rivals like Aetna Inc., Humana Inc. and UnitedHealth Group Inc., which have all largely quit selling Obamacare plans altogether. Because Anthem has been a big player in Obamacare and has filed to stay in markets including Colorado and Virginia, its recent decisions to withdraw from some states have created upheaval. Nevada is following Wisconsin, Indiana and Ohio, states where Anthem plans to exit Obamacare markets almost entirely, leaving empty counties in its wake.

“Planning and pricing for ACA-compliant health plans has become increasingly difficult due to a shrinking and deteriorating individual market, as well as continual changes and uncertainty in federal operations, rules and guidance, including cost sharing reduction subsidies and the restoration of taxes on fully insured coverage,” Anthem said in a statement Wednesday night.

In Nevada, the insurer will offer on-exchange plans in Clark, Nye and Washoe Counties. Clark, the state’s most-populated county by far, is home to Las Vegas. About 81,000 people in those three counties bought Obamacare plans for this year, compared to the 8,000 who selected them in the counties that’ll now be empty.

Three other insurers will have plans in the three counties where Anthem is staying, according to the state’s Department of Insurance. They are Centene Corp., Aetna and UnitedHealth.

Korbulic, the Nevada exchange’s executive director, said she and other state officials are trying to convince the four companies to expand into or come back to some of the empty counties. They have until late September to make their final decisions.

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