Health Care

Insurer plans to expand Obamacare offerings into Missouri counties in KC area

Minnesota-based Medica announced this week it has filed documents with the Missouri Department of Insurance to sell its Select plan under the Affordable Care Act in Cass, Clay, Jackson and Platte counties.
Minnesota-based Medica announced this week it has filed documents with the Missouri Department of Insurance to sell its Select plan under the Affordable Care Act in Cass, Clay, Jackson and Platte counties.

Another insurance company has filed to sell plans on the Affordable Care Act exchange in Kansas City next year, possibly bringing the total to three just one year after it appeared the city might have only one option.

Minnesota-based Medica announced this week it has filed documents with the Missouri Department of Insurance to sell its Select plan in Cass, Clay, Jackson and Platte counties.

The plan, which limits hospital coverage to St. Luke's Health System locations, is now offered only to residents of Johnson and Wyandotte counties in Kansas.

“We’re really excited to be able to expand our service area and expand that partnership with St. Luke’s," said Geoff Bartsh, Medica's vice president and general manager of individual and family business. "We think we’re going to have a competitive product out there and our goal is to get to know the folks in Missouri and begin building trust with them.”

Medica's announcement is the latest in a slew of market changes for the area's Affordable Care Act, commonly called Obamacare, marketplace.

Major insurers like UnitedHealthcare and Blue Cross and Blue Shield of Kansas City have gotten out, but new players like Medica and Centene, with its "Ambetter" plans, have jumped in.

The one constant in the Missouri counties of the metro over the last few years has been Cigna. If the Connecticut-based insurer and Centene stay in for 2019, then people in Jackson, Clay, Cass and Platte counties will have three companies to choose from when open enrollment starts in November.

Johnson County and Wyandotte County have also seen turnover the last few years. But according to the Kansas Insurance Department, Medica, Centene and Blue Cross Blue Shield of Kansas have again filed their intent to sell 2019 plans that are similar to what they're offering this year. That would be Medica throughout the state, Centene in Johnson County and Wyandotte County, and BCBS Kansas in every county except Johnson and Wyandotte.

The Missouri Insurance Department said it would have more information on its filings July 25.

A Cigna spokesman said the company won't yet comment on its 2019 plans yet, and a Centene representative didn't respond.

Three insurers would be a significant turnaround from this time last year, when Blue KC's exit left the possibility of Cigna being the last insurer standing in Kansas City on the Obamacare marketplace, which offers federally subsidized coverage for people who aren't insured through an employer or government program.

As other insurers have pulled back from Obamacare, Medica and Missouri-based Centene are going all in.

Medica also announced this week that it's moving into Oklahoma. Bartsh said the company is capitalizing on opportunities created when other companies exit and thinks it has found a viable business model where others struggled.

Part of that model is the narrower network, like the Select plan that uses an exclusive agreement with St. Luke's to control costs. Bartsh said that sort of plan is becoming common across the country. There was some confusion about it when it rolled out in Wyandotte and Johnson counties this year, he said, but overall consumers seem to like it.

Robert Bonney, the senior vice president for non-acute services and business development at St. Luke's, said in a statement that the health system is looking forward to the expansion of the Medica Select plan.

"By expanding Select by Medica into Missouri, St. Luke’s patients buying insurance on the Missouri health insurance marketplace will continue to have access to convenient and comprehensive health care services close to where they live and work,” Bonney said.

Bartsh said Medica in the future would explore expanding its Obamacare offerings into a ring of 25 northwest Missouri counties where Centene is the only insurer.

Though Republicans in Congress repealed the tax penalty for Americans who don't carry insurance, Bartsh said insurers have more regulatory certainty after efforts to scrap the rest of the ACA failed.

"We stuck it out and I think as we look across our expanded service area, things have stabilized to some extent, which is great,” Bartsh said.

An anti-ACA lawsuit brought by 20 Republican-led states, including Kansas and Missouri, could be "a game-changer," Bartsh said. But he said the upheaval that has occurred since the law passed in 2010 means that the remaining insurers are prepared for the game to change.

“We’ve had to become really flexible," Bartsh said. "We’ve had to kind of think ahead of what some of the potential changes might be and have a plan in place to react to them as we move forward.”

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