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Pullout by United Health would hurt competition in state’s exchange


A bright outlook for the Mississippi insurance exchange for 2016 is threatened by the possible pullout in 2017 of its biggest insurer.

The United Health Group says it may depart from all the Affordable Care Act exchanges because they are a drain on its bottom line.

United Health plans to expand its coverage to all 82 counties in the state starting Jan. 1.

But if it pulls out of the exchanges a year later, that would leave 50 of Mississippi’s 82 counties with only one insurer, thus eliminating competition in those counties.

Thirty-two counties would have two carriers.

The company projects a loss of $425 million in 2015.

Not enough people are buying policies in the exchanges and those that do are using them  extensively, the company says.

“I think it’s a shot across the bow,”  Mississippi insurance Commissioner Mike Chaney said of United’s warning.

Kaiser Health News reported Nov. 20, the day after United’s statement, that it was “a move some see as an effort to compel the Obama administration to ease regulations and make good on promised payments.”

Those “promised  payments” – a redistribution of profits from insurers that  did especially well to offset losses, as in United’s case – thus far have paid “only about 13 cents on the dollar of what was promised, mainly because fewer insurers than expected made money,” Kaiser Health reported.

Those whose income is between 138 percent and 400 percent of the federal poverty level may apply for the subsidy. So a one-person household can make between $16,506.60 and $46,680.

Mississippi leads the nation in participation in tax credits, with 95.4 percent of those who apply receiving a tax credit. Perennially one of the most unhealthy states in the union, its individuals got an average subsidy of $351 a month, also the highest in the nation, according to the federal Centers for Medicaid and Medicare.

Yet the Mississippi Department of Insurance recently told the Mississippi Business Journal that many people’s premiums through the exchange will fall in 2016.

The department said Ambetter Magnolia’s average premium will decrease 2.9 percent, followed by Humana Insurance, with a decrease of 0.2 percent. United’s will increase by 6.6 percent.

The average premium figures are not available.

Of the 104,000 enrollees in the Mississippi exchange, about 65,000 are with United, followed by Humana Insurance with less than 30,000 and Ambetter Magnolia between 23,000 and 25,000, according to department records.

Things have been worse in Mississippi, Chaney said. At one time, 36 counties had no carrier doing business in the exchange, he said.

Still, if United were to pull out of Mississippi, it would be hard to find a replacement due to mergers with major carriers, Chaney said.


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About Jack Weatherly


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