Humana Will Reduce Its Public Exchange Presence by Nearly 90% in 2017

Early in August commercial health insurer Humana Inc. disclosed it was joining a growing list of big insurance companies scaling back participation in public health exchanges.

Now more detail is emerging on where Humana will—and will not—participate in public exchanges for the 2017 benefits enrollment season that starts on Nov. 1. For the 2016 benefits enrollment season Humana offered individual health insurance products on public exchanges in 15 states, a number the company will trim to 11 states in 2017.

But more important, Humana will only sell insurance online via public exchanges in 156 counties in 2017, a decrease of 88% from 1,351 counties in 2016, according to Humana’s just filed second quarter earnings report with the U.S. Securities and Exchange Commission.

As a result Humana also says it anticipates writing about $750 million to $1 billion worth of exchange-related health insurance policy business next year, down from $3.4 billion in 2016.

Humana currently offers exchange policies in Alabama (Birmingham, Huntsville); Arizona (Phoenix, Tucson); Colorado (Colorado Springs, Denver, Boulder, Fort Collins, Greeley); Florida (Fort Lauderdale, Daytona Beach, Miami, Orlando, Port Charlotte, West Palm Beach, Tampa Bay, Lakeland); Georgia (Augusta, Atlanta, Columbus, Macon, Savannah); Illinois (Chicago, Peoria, Rockford, Springfield); Kentucky (Covington, Lexington, Louisville); Louisiana (New Orleans); Michigan (Detroit, Grand Rapids); Missouri (Kansas City, Joplin, Springfield): Mississippi (Jackson and various counties); Ohio (Cincinnati, Dayton); Tennessee (Knoxville, Memphis, Nashville); Texas (Austin, Corpus Christi, Houston, Rio Grande, San Antonio, Waco) and Utah (Salt Lake City).

Humana has yet to name all states where it will no longer offer coverage through the public exchanges next year, but Utah is at least one state where it has notified the Utah Department of Insurance where it will no longer participate.

Humana has yet disclose losses to its exchange related business but going forward will only write policies where the public exchange market is “stable.”

“Humana aims to maintain individual commercial on-exchange coverage options in markets where it expects to be able to offer a high-quality and ultimately, stable health plan,” Humana says in its second quarter report. “The company will continue to work closely with the current and future federal administrations and state governments to enhance coverage options for individuals.”

In 2016 Humana provided coverage for nearly 500,000 consumers through its exchange business, the company says.

Humana joins a growing list of big commercial insurers pulling back from the public exchange market. The biggest commercial health insurer—United Health—for the 2016 benefits enrollment season that began Nov.1 of last year and ended Jan. 31 provided exchange coverage in 34 states. But for the 2017 benefits enrollment season United will only participate in three exchange markets in New York, Nevada and Virginia. In April United Health said it lost $475 million in 2015 from the marketplace plans and was on target to lose $650 million in 2016.

“All of the big commercial insurers, including Blue Cross plans, have been struggling with the public exchange market,” says Pat Kennedy, founder of healthcare payments consulting firm PJ Consulting.

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