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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Leslie Small

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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