Last month, state officials asked potential insurers to specify waivers of state laws or rules that might allow them to newly offer coverage to residents buying insurance outside the seven-county metro area.
No applicants surfaced as of Friday's deadline. Two county-based groups that manage care for
In a statement on Monday, the
MNsure is one of several government-run exchange markets that were launched in late 2013 under the federal Affordable Care Act.
The websites are an option for people who don't get coverage from an employer or government programs like
Currently, about 5 percent of
There's growing concern nationally about a lack of competition on exchanges next year as health insurers pull back due to mounting financial losses.
That could leave some of those counties with options from just two carriers. It's not clear if there are any other potential gaps in competition, since ongoing negotiations between insurers and state regulators about 2017 options aren't public.
State requested proposals
The state departments of health and commerce -- not MNsure -- issued the request for proposals (RFP) in August without specifying if they had concerns about a lack of competition in particular counties. Instead, regulators said they were interested in boosting competition in a market where
"Changes in the
While the RFP highlighted the need for choices among rural consumers, it said responders might also have the chance to sell in the metro area and in the "off-exchange" portion of the individual market.
Two county-based purchasing organizations sent letters to regulators last week saying they were interested in the chance of selling coverage in the individual market, but raised concerns about the timeline for doing so in 2017.
"Given the aggressive timeline of the RFP with the proposed start date of
County-based purchasers are governmental groups that manage care for people in the state's Medical Assistance and MinnesotaCare programs. They are an alternative to HMOs that manage care for most state residents in the public insurance programs.
Issues in rural areas
Competition can be a problem in rural counties because insurers can't sell policies across a large population base, and they sometimes struggle to get competitive prices from doctors and hospitals in small communities, said
"There's not a lot of incentive for insurance companies to go into rural areas," she said.
Across the country, pullbacks announced by insurers mean that an estimated 2.3 million enrollees in health exchange coverage, or 19 percent of all enrollees, could have a choice of a single insurer in 2017, according to an August analysis from the
The report also said the share of all counties where a single insurer sells exchange plans is likely to increase from 7 percent to 31 percent next year.
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