Clayton, Mo.-based Centene announced Tuesday morning that it would sell 2018 individual and small group health plans in Kansas and Missouri through the Affordable Care Act, commonly called Obamacare.
The insurer’s decision potentially fills the hole created when Blue Cross and Blue Shield of Kansas City announced it was pulling out of the ACA exchanges, leaving Kansas City’s core counties down to one insurer and leaving bare 25 northwest Missouri counties just outside the metro area.
Blue KC cited $100 million in losses on the exchange, as well as uncertainty surrounding Republican efforts to repeal and replace Obamacare. But in a news release Tuesday morning, Centene said it had been successful serving 1.2 million members on exchanges in other states, 90 percent of whom are eligible for federal subsidies based on income.
“Centene recognizes there is uncertainty of new healthcare legislation, but we are well positioned to continue providing accessible, high quality and culturally-sensitive healthcare services to our members,” Michael F. Neidorff, the for-profit company’s chairman, president and CEO, said in a statement. “Centene has demonstrated disciplined execution, agility and capacity to successfully navigate industry changes to the benefit of our members, customers and shareholders.”
Centene also plans to expand into the Nevada exchange.
The company already has relationships with medical providers in Kansas and Missouri because it holds state contracts to administer Medicaid plans. Its Missouri Medicaid subsidiary is called Home State Health Plan, and its Kansas Medicaid, or KanCare, subsidiary is called Sunflower State Health Plan.
“Though we were pleased to hear the news this morning about Centene’s upcoming plans for Missouri in 2018, we do not have any final details relating to the areas of Missouri in which Centene plans to be active,” Missouri Department of Insurance Director Chlora Lindley-Myers said in a statement. “However, I want Missourians to know the department will continue working with all parties and doing everything it can to ensure they and their families have choices when it comes to their health coverage in 2018 and beyond.”
Clark Shultz, the deputy insurance commissioner for Kansas, said commissioner Ken Selzer had been working to bring Centene in for months and Tuesday’s news was “very encouraging,” but the department did not have all the details yet.
“They’re just going to presumably be in Wyandotte (County) and Johnson County,” Shultz said. “They, at this point, have not filed any of their forms. We’ll be working with them to get that completed.”
About 26,000 exchange customers in those two counties were left with only Medica after Blue KC pulled out, and Medica has not said yet whether it will expand its Kansas enrollment past 10,000 statewide next year.
Kansas Lt. Gov. Jeff Colyer, a Republican, said he had encouraged Centene to enter the marketplace in those two counties and commended the company for it.
“However, this is an interim solution,” Colyer said in a prepared statement. “Obamacare is clearly unsustainable and we look forward to the federal government working toward a permanent solution.”
Blue KC’s exit left Jackson, Clay, Cass, Ray and Platte counties in Missouri with only Cigna on the exchange for 2018, and Cigna officials have not yet said whether they plan to stay in. There are about 45,000 exchange customers in those counties and an additional 20,500 in the northwest Missouri counties that are bare.
In a series of emails sent in April, Marc Alcedo, the head of state government affairs for Cigna Healthcare, arranged for a May 10 meeting with other Cigna officials and Missouri insurance regulators to discuss the company’s 2018 individual market strategy.
The Kansas City Star got the emails through an open-records request filed with the Missouri Department of Insurance. Neither Cigna nor the insurance department has answered questions about what was said.
“Our participation in individual markets is contingent on market conditions and regulatory approval,” Cigna’s public relations manager, Jim Angstadt, said. “Approvals and final plan decisions typically take place in the third quarter and we will continue to assess our participation based on the evolving rules, regulations and design of the marketplace throughout this process.”
Initial premium rate requests for 2018 are due to the insurance departments of both states next month.