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Anthem leaves ACA markets in Missouri and Kentucky

In Kentucky, Anthem will reduce its 2018 individual exchange plan offerings by half, from selling plans in 120 counties to 59 in 2018.

Susan Morse, Executive Editor

Anthem is scaling back its marketplace footprint in Missouri and Kentucky.

Beginning in 2018, Anthem will offer individual health plans on and off the exchange in 68 counties in Missouri that would otherwise not have health insurance coverage, the insurer said.

However, this represents a reduction of 17 counties, as Anthem sold ACA plans in 85 counties this year.

[Also: Last county without ACA insurer gains carrier]

Anthem sells plans throughout Missouri excluding 30 counties in the Kansas City area where it is not licensed to operate, the insurer said.

In Kentucky, Anthem will reduce its 2018 individual exchange plan offerings by half, from selling plans in 120 counties to 59 counties in 2018.

Anthem said planning and pricing for ACA-compliant health plans has become increasingly difficult due to a shrinking and deteriorating individual market and federal uncertainty over cost sharing reduction subsidies and the restoration of taxes on fully insured coverage.

[Also: New Anthem policy cuts hospital outpatient payment for MRIs, CT scans in 5 states]

Anthem has already reduced its footprint in the individual ACA market in Virginia, Ohio, Indiana, Nevada and Wisconsin.

Anthem said the decisions in Missouri and Kentucky were made after significant dialogue with state leaders and regulators.

[Also: Anthem cuts opioid prescriptions by 30 percent, 2 years ahead of goal]

"While we are pleased that some steps have been taken to address the long term challenges all health plans serving the Individual market are facing, the Individual market remains volatile," Anthem said by statement. "A stable insurance market is dependent on products that create value for consumers through the broad spreading of risk and a known set of conditions upon which rates can be developed."

Individuals who have employer-based insurance, Medicaid, Medicare Supplement and Advantage health plans, or individuals enrolled in "grandfathered" plans purchased before March 2010, or transitional plans, are not affected by the decision.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com