Recession, ACA Exchange Stability Drive Insurer Expansions

Given that enrollment in the Affordable Care Act (ACA) exchanges has basically flatlined at around 11.4 million — a lower level than originally projected and just a small fraction of the overall health insurance market — one might not expect insurers to view the exchanges as a growth opportunity. But recent moves by some of the country’s largest payers suggest otherwise.

Centene Corp., for example, said on Sept. 11 that it will widen its ACA marketplace footprint by selling plans in “nearly 400 new counties” next year. The St. Louis-based company will increase its presence in 13 of the states where it already sells plans, plus enter two new states: Michigan and New Mexico. In total, it will sell its Ambetter-branded plans in 22 states in 2021. Centene, which is also a Medicaid managed care powerhouse, has consistently expanded into new ACA markets since the exchanges’ inception — even when many of its publicly traded peers pulled back (see infographic, p. 8).

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