Government health insurance markets holding up--barely

Bruno Cirelli
Giugno 24, 2017

The company said that partnerships with health systems like the Cleveland Clinic to offer new plans in northeastern OH will allow it to be successful.

Despite losing millions on ACA plans in the last two years, Oscar Health is betting on the individual market and expanding its footprint into three additional states.

Insurers that will participate in the health program in some states are expected to send their proposed rates Wednesday, a deadline that was postponed several weeks by the Trump administration to give companies more time.

The company, which did business in New Jersey in 2015 and 2016, filed to return to the state with offerings to businesses and individuals in 14 counties. "For all of the political noise, there are simply too many lives at stake for representatives in Washington, D.C. not to do what's right for the people", Oscar CEO Mario Schlosser said in a statement posted on the company's site Wednesday. The Senate will likely vote on that bill next week. It filed to expand into certain counties in Ohio, New Jersey, and Tennessee.

The company says it has filed a request with the federal government to begin selling plans in Travis, Williamson, Hays, Comal and Guadalupe counties during enrollment this fall. Schlosser told Modern Healthcare last week that the individual market would surely be different in the future, but is betting it will be "a good market to deliver health insurance in". Its decision would cover the yawning gap left by Aetna and the state Blue Cross plan, which exited the market for next year and raised the possibility that no carrier would offer coverage to the bulk of the state's residents. "We're not offering a conventional insurance product", he said of Oscar and Cleveland Clinic's plans.

The Blue Cross-Blue Shield insurer Anthem said Wednesday that it will leave exchanges in Wisconsin and its home state of Indiana.

Despite uncertainly over the future of US healthcare that has prompted major health insurers to pull out of several markets, upstart provider Oscar Health on Wednesday said it has filed to sell health insurance to individuals through Obamacare exchanges in a total of six states in 2018.

Oscar's expansion plans are subject to regulatory approval. expansion are subject to regulatory approval. The company said the exorbitant rate increase is necessary to remain in a market where all other insurers have fled. Insurers are seeking an 18 percent increase, on average, for the most popular so-called silver plans. Oscar hangs the majority of its success on those exchanges and it was the ACA that helped Oscar climb to its almost three billion dollar valuation when it launched four years ago.

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