Three Major Insurers Will Expand ACA Exchange Footprints in 2023

by Leslie Small

 

Galvanized by a growing, stable Affordable Care Act exchange market and a looming dropoff in Medicaid membership, some of the country’s largest health insurers in 2023 are once again expanding their ACA marketplace footprints. At the same time, two startup insurers are pulling out of select markets — although one policy expert tells AIS Health that those moves mainly reflect how difficult it is to compete against companies with dominant market shares.   UnitedHealth, Cigna, Aetna all branch out  UnitedHealthcare confirmed via email to AIS Health on Sept. 8 that it plans to enter Kansas, Mississippi, Missouri and Ohio for the 2023 plan year. That expansion, if approved by regulators, would put the insurer in a total of 22 states.  The news from UnitedHealthcare comes on the heels of Cigna Corp. revealing that next year it will enter the exchange market in three new states — Indiana, South Carolina and Texas — and add new counties in others. All told, the expansion will give Cigna a presence in 363 counties spanning 16 states.   “We choose new markets based on where we have strong provider partnerships that enable us to offer local plans that meet our customers’ unique needs and deliver affordable care and superior health outcomes,” a Cigna spokesperson tells AIS Health via email.  CVS Health Corp.-owned Aetna, meanwhile, revealed on Sept. 8 that it plans to have a marketplace presence in 12 states next year. The company is adding California, Delaware, Illinois and New Jersey to the eight states it entered in 2022 after a four-year hiatus from the exchanges.   Two startups pull back from the exchanges  Those expansions stand in contrast to what’s happening at two startups that previously were on an expansion spree themselves: Oscar Health, Inc. said earlier this year that it will stop offering individual market plans in Arkansas and Colorado. And Bright Health Group, Inc. said it will exit the exchange markets in six states.   Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation, tells AIS Health that Oscar and Bright’s market exits differ from the situation earlier in the history of the ACA marketplaces when many insurers withdrew.    “It’s not the same as it was in 2017 where everybody was having a bad experience,” she says. “Now, it’s just like, OK, you have to be competitive to succeed here. I do think that the smaller new companies, unfortunately, are at a big disadvantage.”

 

From Health Plan Weekly

 

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