Obamacare insurer pulls out of rural Virginia leaving coverage gaps

Virginia-based health insurer Optima announced Wednesday it was pulling out many rural counties in the state, potentially creating a gap in coverage for 70,000 people. From the Hill:

Optima said it plans to exit about half of the 35 counties that it served in 2017, after previously planning to cover nearly the entire state next year. The move would leave 63 of Virginia’s 95 counties without an insurance option for 2018…

Optima also said it would be raising premiums by 81 percent for any customer who doesn’t qualify for subsidies from the federal government. However, this would only affect about 30 percent of its customers.

A statement published by Optima attributed 23% of the 81% premium hike to uncertainty over cost-sharing payments. Most of the remaining increase was attributed to the withdrawal of other major insurers from the state.

Until today, it appeared as if all of the potential gaps in coverage around the country had been filled. An interactive map at the Kaiser Family Foundation shows that counties in Washington, Nevada, Missouri, Indiana, Ohio, and Tennessee which might have gone uncovered next year all found an insurer willing to cover them.

Also today, Anthem announced it was pulling back in about half the counties it covers in Kentucky. From Reuters:

U.S. health insurer Anthem Inc said on Wednesday that it will offer Obamacare plans in only about half of the counties in Kentucky next year, after covering the whole state in 2017.

The insurer said it will offer the healthcare plans in 59 counties in the state in 2018. It said all 120 counties in Kentucky will still have a carrier offering plans next year.

So the important difference here is that in Kentucky, every county still has at least one insurer to count on, meaning no one will be left without an option to buy insurance. Saturday, the Washington Post published an editorial arguing that the lack of any bare counties next year was proof Obamacare was “still not collapsing.” Perhaps Virginia will find an insurer to cover those 63 bare counties but time to do so is running out.

Jazz Shaw Apr 12, 2021 2:31 PM ET