Anthem agrees to cover “bare” counties in Virginia’s Obamacare market for 2018

Sept. 15--In the latest Obamacare twist, Anthem announced Friday it will cover Virginia areas that were at risk of not having any insurers in next year's federal insurance exchange.

The move follows a turbulent month in the individual federal insurance exchange that's officially known as the Affordable Care Act.

In mid-August, Anthem pulled out of all but a handful of localities in Virginia, citing the uncertainty of federal "cost-sharing reductions," which help customers of modest incomes pay for insurance.

On the heels of that, locally based Optima Health announced Sept. 6 it would curtail its coverage area, from 116 localities to 30. That, along with UnitedHealthcare's and Aetna's withdrawal earlier in the year, meant 63 counties and cities would "go bare," meaning they would have no providers on the Obamacare exchange.

Most were in the western, rural part of the state, but the Eastern Shore also had counties with no carriers, along with scattered areas throughout the state.

State health and insurance officials were scrambling to find a carrier to fill the gap, as Virginia was the only state to have some counties and cities with no insurance carriers on the exchange.

In response to the pleas of those state regulators and the governor, Anthem announced it is revising its plan for 2018 to include individual plans in the cities and counties in Virginia that had no insurers, along with a handful of localities it had already filed to cover in the far western part of the state.

"Sixty-three of these cities and counties would otherwise not have access to individual market health plans," said the Anthem release, which said the decision would help an estimated 70,000 Virginians to maintain access to health care coverage. "Anthem will remain focused on developments in the individual marketplace and will continue to advocate for solutions that will stabilize the market and allow us to once again, offer individual insurance coverage throughout the state of Virginia in the future."

Optima will continue to offer Obamacare coverage in Hampton Roads, the only carrier here. Currently, Optima offers Obamacare individual plans in 116 localities, most of which are in areas where Sentara Healthcare has facilities. Earlier this year, Optima was going to expand to 126 localities next year. But the volatility of the market caused it instead to reduce coverage to 30 cities and counties in 2018.

Even so, the number of Virginians covered by Optima is estimated to increase from 17,000 to 75,000 because of the exit of other insurers.

Gov. Terry McAuliffe released a statement thanking Anthem for expanding its coverage area to include areas that would have gone without a carrier: "Their decision to make sure every locality in Virginia is served is a recognition that all Virginians need access to health care and a direct reflection of the intense effort by our administration, our Senators Mark Warner and Tim Kaine and our entire congressional delegation to convince Anthem of the value of continuing to offer plans in these localities."

McAuliffe said it doesn't change the fact "that President Trump and Republicans in Congress are actively working to undermine the Affordable Care Act, to the detriment of states like Virginia. It is imperative that leaders in Washington take quick action to make sure the Marketplace in Virginia and those across the country are sustainable for years to come."

The deadline for insurers to submit insurance coverage plans and rates for 2018 is Sept. 27, so there still could be some changes in the market.

These are the counties Anthem will be covering on the Virginia ACA individual market:

Accomack, Alleghany, Augusta, Bath, Bland, Botetourt, Bristol City, Brunswick, Buchanan, Buena Vista City, Caroline, Carroll, Covington City, Craig, Culpeper, Dickenson, Emporia City, Essex, Fauquier, Floyd, Franklin, Franklin City, Frederick, Galax, Giles, Goochland, Grayson, Greensville , Henry, Highland, King and Queen, King William, Lancaster, Lee, Lexington, Madison, Martinsville, Middlesex, Montgomery, New Kent, Northampton, Northumberland, Norton, Orange, Page, Patrick, Powhatan, Pulaski, Radford City, Rappahannock, Richmond County, Roanoke County, Roanoke City, Rockbridge, Russell, Salem City, Scott, Shenandoah, Smyth, Southampton, Staunton, Tazewell, Washington, Waynesboro, Westmoreland, Winchester City, Wise, Wythe.

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