Anthem CEO on Ohio exit: 'those markets are not sustainable'

Anthem CEO Joseph Swedish announced earlier this month that his company would be pulling out of the Obamacare exchange in Ohio. Yesterday Swedish appeared on CNBC and defended that decision saying some Obamacare markets are not sustainable:

“It’s a complicated decision,” Swedish said. He continued, “At its core, we’ve been saying repeatedly now for well over a year, we’ve very carefully evaluated the sustainability of the marketplace under the Affordable Care Act.

“And we’ve also said that it’s possible without the right kinds of changes with respect to funding levels and other regulations associated with the Affordable Care Act that we may have to exit certain markets because those markets are not sustainable.”

Swedish is talking, in part, about the continuation of cost-sharing payments which have been extended under President Trump but which could still end at any time. CNBC reports Swedish said the market might have to evolve to reach sustainability:

“Adjustments have not occurred and certain decisions have not been made to further strengthen or stabilize that marketplace. … [W]e’ve come to sort of a fork in the road in terms of our inability to service our communities,” Swedish said.

“Fixing the individual market, fixing the Affordable Care Act and possibly getting to some new model of delivery for the individual marketplace will evolve so that sustainability is created,” he said.

Last week the number of insurers pulling out of Obamacare markets around the country was accelerating, leaving up to 45 counties with no insurer at all for 2018. This week supporters of the law are breathing a sigh of relief as several insurers offer to expand coverage into new states. From Reuters:

Centene Corp, one of the largest players in the Obamacare individual insurance market, said on Tuesday it would expand into three new states in 2018, despite uncertainty over the future of the legislation under President Donald Trump’s administration.

The company said it plans to enter Kansas, Missouri and Nevada in 2018, as well as expand its operations in six existing markets: Florida, Georgia, Indiana, Ohio, Texas, and Washington.

Also, yesterday, the Cleveland Clinic announced it was partnering with Oscar Health to offer plans in Ohio. From CNN:

On Thursday, the two businesses announced that they’ll work together to offer individual health insurance plans to consumers in five counties in northeast Ohio.

The new plan, which is slated to be available both on and off the Obamacare exchanges, will give members access to facilities operated by Cleveland Clinic.

Again, after a week of very bad news last week, Obamacare’s health improved a bit this week. That doesn’t mean it is doing well overall in terms of cost or competition but it does show that the pendulum of uncertainty can swing both ways.