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Molina Healthcare Leaving Wisconsin’s ACA Exchange

National Insurer Won't Sell Affordable Care Act Policies In 2018

Doctor's office
Morgan (CC-BY)

California-based health insurer Molina Healthcare is pulling out of Healthcare.gov in Wisconsin.

Molina announced Wednesday it will not be selling policies under the Affordable Care Act marketplaces in Wisconsin and Utah.

The decision affects 30 counties in Wisconsin and almost 29,000 people. Molina was reviewing market participation for 2018 in other states before making the decision, a press release from the company states.

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“Based upon revenue and cost trends observed in the second quarter of 2017, we now believe that Marketplace performance in the second half of 2017 will fall substantially short of previous expectations. Marketplace performance has been most disappointing in Florida, Utah, Washington and Wisconsin,” the release reads.

This is the third national insurer to exit Wisconsin’s federal marketplace. Earlier Anthem and Health Tradition announced they wouldn’t sell plans on Healthcare.gov.

“So what I think this shows is a continual trend where the national carriers are not as interested in doing business — at least Obamacare business in our state — whereas our state-based carriers, and there are many in our state, have continued to be interested in offering ACA policies and seem committed to the market,” said Donna Friedsam, health policy programs director at UW Population Health Institute.

The ACA marketplace, which relies on individuals being required by law to buy insurance, could be less stable if the mandate goes away. Another potential factor in the stability of the marketplace is whether the federal government will continue subsidy payments to insurers to offset deductibles and co-pays for low-income consumers

“Virtually all of the carriers in their rate filings with federal officials requesting premium increases mentioned the continuing uncertainty of the policy environment,” Friedsam said.

There are still 12 insurance companies in Wisconsin intending sell coverage on the marketplace.

“Which is quite a lot relative to other states. That being said, we don’t like to see exits from the market,” Friedsam said.