Each Kentucky county has only one insurer with Obamacare exchange plans for 2018 after Anthem pulls out of 61 counties

Kentucky Department of Insurance map shows Anthem's
remaining counties in blue, Care Source counties in peach.
(An earlier version of this caption transposed the colors.)

By Melissa Patrick
Kentucky Health News

Anthem Blue Cross and Blue Shield will no longer offer Obamacare exchange plans statewide, leaving all Kentucky counties with only one choice in 2018.

Anthem offered plans in all 120 Kentucky counties last year, and had earlier planned to do the same, but scaled back to 59 counties in 2018 citing a "shrinking and deteriorating individual market, as well as continual changes and uncertainty in federal operations, rules and guidance, including cost sharing reduction subsidies and the restoration of taxes on fully insured coverage. "

CareSource will cover the other 61 Kentucky counties. The Hill notes that Anthem had already announced plans to scale back participation in or leave the Indiana, Wisconsin, Missouri, Nevada and Ohio exchanges.

The Kentucky Department of Insurance also approved rate hikes for Anthem and CareSource's exchange plans, 41.2 percent and 56 percent respectively. The rate filings are subject to federal approval by Sept. 27.

These rates affect only those who get their health insurance on healthcare.gov and not those who get insurance in other ways, like employer plan, Medicare or Medicaid. Last year, more than 81,000 Kentuckians got their health insurance on the exchange. It should be noted that these rate hikes are just an average. Individual's rates will also factor in the plan type, smoking habits, age and place of residence, among other things.

These hikes are largely due to the uncertainty around whether the Trump administration will continue to pay the cost sharing reductions that help lower-income people afford their health insurance. Right now they are being paid on a month-to-month basis. Regardless, the insurance companies are responsible for them and because of the uncertainty have passed this cost onto the consumer.

"We remain hopeful that the federal government will continue providing CSR funding because it is a benefit to consumers and helps them afford their premiums," Bob Brett, vice president for CareSource, told Jacob Dick of The Messenger-Inquirer. "Like many insurers across the country, CareSource prepared multiple rate scenarios to factor in the uncertainty around CSR subsidies."

All this comes as a bipartisan group in Congress have started meeting to find ways to stabilize the Obamacare insurance markets -- even calling for a long-term extension of the CSR payments this week, though this recommendation comes a too late to influence next year's rates.

The state Insurance Department says every county has one insurance provider offering both on- and off-exchange plans, though the insurer options will be more limited than in prior years.

An open enrollment checklist prepared by the state notes that all plans have changed from last year and among other things points out that all 2018 plans are HMO plans that require the insured to only use in-network providers, except in an emergency.

“The driving force behind today’s insurance market is uncertainty and instability but, despite these factors, the department remains committed to providing the best possible outcome for Kentuckians and will continue to look for solutions to lessen the burden on consumers,” said Insurance Commissioner Nancy Atkins in the news release.

The open enrollment for 2018 plans has been shortened this year from three months to 45 days. It will run from Nov. 1 to Dec. 15.

Murray State University's NPR station, WKMS, list the 61 counties that Anthem will no longer offer plans in 2018, including: Anderson, Bath, Boone, Bourbon, Boyd, Boyle, Bracken, Bullitt, Campbell, Carol, Carter, Casey, Clark, Clay, Elliott, Estill, Fayette, Fleming, Floyd, Franklin, Gallatin, Garrard, Grant, Greenup, Harrison, Henry, Jackson, Jefferson, Jessamine, Kenton, Knox, Larue, Laurel, Lincoln, Madison, Marion, Mason, Menifee, Mercer, Montgomery, Morgan, Nelson, Nicholas, Oldham, Owen, Pendleton, Perry, Powell, Pulaski, Robertson, Rockcastle, Rowan, Scott, Shelby, Spencer, Taylor, Trimble, Washington, Whitley, Wolfe and Woodford.

9/14/17 Correction: The caption on the picture has been corrected to reflect that Anthem will be selling plans in the blue counties and CareSource will be selling plans in the peach counties.