Individual Exchange: Anthem and CareSource | Courtesy KY Department of Insurance

The Kentucky Department of Insurance announced on Wednesday that it had approved a rate hike for Anthem of 41.2 percent and CareSource of 56 percent for Kentucky’s Affordable Care Act customers next year.

Anthem, based in Indianapolis, said on Wednesday that it would reduce its 2018 footprint in Kentucky and would only offer plans on and off the exchange in 59 counties, down from 120 counties. CareSource, the nonprofit managed care company based in Dayton, will fill the gap as shown in the map above.

No other insurer is offering plans for Kentuckians on the federal exchange.

In an emailed statement, Anthem said, “After significant dialogue with state leaders and regulators Anthem has made the difficult decision to revise our rate filing for our 2018 Individual plan offerings in Kentucky.”

Bob Brett, vice president for CareSource, said in a statement, “CareSource remains committed to serving Kentuckians through the Health Insurance Marketplace. We understand how important health care is to individuals and their families and we’re proud to offer Kentuckians in our 61-county coverage area our quality Marketplace product.”

In a press release, the Kentucky Department of Insurance noted that no Kentucky county would be left uncovered, with one insurance provider operating both on and off the exchange in each Kentucky county, but that insurer options would be more limited than in prior years because of ACA, also known as Obamacare.

“The damage caused to hardworking Kentuckians under Obamacare is evident in the rate increases that are required each year to sustain the healthcare market and the decrease in insurer options,” said DOI Commissioner Nancy Atkins. “The uncertainty in the marketplace and Obamacare mandates are making it harder and harder for Kentuckians to access affordable healthcare insurance each year.”

The rates affect only those 78,800 Kentuckians who get their insurance on the federal health care exchange — not those who get insurance in other ways, such as from an employer plan, Medicare or Medicaid.

The rates represent averages, which means individual premiums can be different as they will depend on factors including age, smoking habits and geographic location. Enrollment for the 2018 plans will begin on Nov. 1. The state insurance department created a step-by-step document to prepare consumers for open enrollment.

The federal and state exchanges – Kentucky had one called Kynect, established under former Gov. Steve Beshear, but dismantled under Gov. Matt Bevin – are a central part of the ACA, known informally as Obamacare. They allow people who do not have access to health care through their employers to sign up for insurance plans and federal subsidies.

However, in the last two years, some insurers, including Louisville-based Humana, have said that the exchanges are primarily attracting sicker people whose health care premiums are not enough to pay for their health care.

Humana said that it lost hundreds of millions of dollars from ACA customers last year. The company will no longer offer any plans on the exchanges for next year — but that impact on Kentucky was muted, as the insurer offered plans in less than a dozen counties here.

ACA customers and state officials breathed a sigh of relief when Anthem, the sole provider of ACA insurance plans in about half of the state’s counties this year, said in June that it would continue to offer plans in Kentucky, despite the industry’s uncertainty, related in part to Congress’ failed attempts to repeal the ACA.

Anthem has changed its cost structure in part by making changes to the networks in which people can access doctors under their insurance plan.

The state insurance department said it worked within federal guidelines to extend the preliminary filing deadline and subsequent rate approval deadline. The rate filings are subject to federal approval by Sept. 27.

“The driving force behind today’s insurance market is uncertainty and instability but, despite these factors, the department remains committed to providing the best possible outcome for Kentuckians and will continue to look for solutions to lessen the burden on consumers,” Atkins said in the release.
Mickey Meece contributed reporting. This post has been updated with a statement from CareSource.