WHA Analysis: Insurer Exits Likely to Leave Fewer Choices on WI’s Exchange

WHA CEO calls on Congress to act now to stabilize insurance markets and preserve Wisconsin coverage gains

August 11, 2017

As uncertainty grips health insurance markets throughout the country, people across Wisconsin who buy their insurance through the exchange marketplace could see fewer choices in 2018. 

That’s according to a new Wisconsin Hospital Association (WHA) analysis which provides a synopsis of expected changes for the 2018 benefit year based on announcements to date. Insurers are expected to enter into final agreements with the Centers for Medicare & Medicaid Services (CMS) for offering exchange coverage by the end of September, so additional changes could still happen. 

The analysis accounts for the decisions by Molina Healthcare, Anthem, and Health Tradition Health Plan to exit the Wisconsin exchange, as well as the merger of Gundersen and Unity health plans. WHA’s analysis also factors in the July announcement by Minnesota-based insurer Medica that it will expand into eight new counties in Wisconsin for 2018, increasing its Wisconsin footprint from 13 to 21 counties. 

Maps and a chart developed by WHA depict a trend of fewer choices across Wisconsin. In 2017, all but one county had a choice of two or more insurers offering plans in the exchange. By 2018, WHA projects 10 counties in Wisconsin could have just one insurer, and one county—Menominee—will have no insurers participating in the exchange in 2018.

Overall, 51 counties could lose up to two health insurers on the exchange in 2018 according to the WHA analysis.

Wisconsin is still expected to be in better shape than most other states when it comes to health plan choices and competition in the exchange. Nonetheless, WHA is increasingly concerned about what these trends could mean for the future of the individual market in Wisconsin. 

“We are seeing some troubling developments in the Wisconsin health insurance market driven in large measure by the uncertainty coming out of Washington,” said WHA President/CEO Eric Borgerding. “We believe the time is now for Congress to act and stabilize the individual insurance market.”

“Wisconsin’s uninsured rate has dropped 38 percent since 2013, and the insurance exchange has been an integral part of that reduction,” Borgerding said. “Wisconsin has much at stake in what comes next out of Washington, and something must come next. Inaction is not an option nor is intentionally allowing failure of insurance markets an acceptable strategy or outcome.”

WHA’s analysis and projections are based on the most recent data and information available. Insurers participating in the Wisconsin exchange will be required to sign final agreements with CMS for 2018 exchange participation by September 27.

This story originally appeared in the August 11, 2017 edition of WHA Newsletter