2018 MIDTERM ELECTION

Time: D H M S

UPDATED x4: UHC pulls out of Arkansas, kind of/sort of pulls out of Georgia as well

Thanks to Sabrina Corlette for the heads up:

UnitedHealth Group will stop offering plans on Arkansas' health insurance exchange next year, a spokesman for the Arkansas Insurance Department said Thursday.

The Minnetonka, Minn.-based insurer offered plans this year for the first time, but it didn't submit plans to the department for 2017, department spokesman Ryan James said.

The deadline for insurers to submit such plans was April 1, he said.

This is hardly unexpected news for a couple of reasons. First, UHC made huge waves last November by making a big, dramatic announcement that they might very well drop out of the ACA exchanges altogether next year after taking large losses on exchange enrollees in 2015. As you may recall, this was a very oddly-timed announcement given that they had issued a glowing quarterly report just a month earlier which made it sound like everything was hunky-dory.

So what does this mean for UHC in other states? Well, that's difficult to say. On the one hand, UHC hasn't made any announcement yet as to whether they're pulling up stakes nationally; on the other hand, as several people pointed out, different states have different filing deadlines. It's possible that the only reason Arkansas is the first to make this announcement is because it's just the state with the earliest deadline. UHC may have decided to drop off of the exchanges everywhere but is doing so quietly, with the news being released state by state as their filing deadlines pass.

ASIDE: Does anyone happen to know the state-by-state filing deadlines for 2017 exchange participation? I found this deadline list for 2016, but can't find a similar one for next year...and given that Arkansas deadline appears to have been April 8th last year, it sounds like they may change from year to year?

UPDATE: Thanks again to Sabrina Corlette for this letter from CMS, which lists the latest deadline date for submitting filings for Healthcare.Gov as May 11, 2016.

It also looks like UHC never made much of a splash in Arkansas to begin with. As Patrick Paule notes, they weren't on the exchange at all in 2014 or 2015, only had 521 people enrolled off-exchange last year and only have 704 people enrolled via Arkansas' unusual "Private Medicaid Option" this year. I don't know what their 2016 exchange enrollment total is, but it sounds like it isn't much.

It's not all bad news, however; there are still 4 other carriers who'll be around for 2017: Centene, BCBS of AR, BCBSA and QualChoice Health.

In addition, Arkansas' SHOP exchange is gaining a player next year, although the SHOP program has been almost invisible to date by most ACA-measuring metrics (including mine):

Meanwhile, St. Louis-based Centene Corp., which has offered plans on Arkansas' exchange for individual consumers since the coverage started in 2014, has submitted plans to offer policies next year on the state's small-business exchange.

Currently, Arkansas Blue Cross and Blue Shield is the only company with plans on the small-business exchange.

Centene's Celtic Insurance Co. sells plans under the brand Ambetter Arkansas.

Celtic CEO John Ryan said the company wanted to ensure it will be able to participate in offering subsidized coverage to small businesses under the Arkansas Works legislation that the state General Assembly is considering this week.

UPDATE: Hmmmm...OK, according to Zachery Tracer of Bloomberg News, it's starting to look like UHC might be making good on their threat after all...

UnitedHealth Group Inc., the largest U.S. health insurer, has decided to call it quits in two state Obamacare markets, in the latest challenge to President Barack Obama’s health-care overhaul.

The insurer won’t sell plans for next year in Georgia and Arkansas, according to state insurance regulators. Tyler Mason, a UnitedHealth spokesman, confirmed the exits and declined to say whether the company would drop out of additional states.

...Including UnitedHealth, Georgia has nine health insurers that currently offer ACA polices, according to Glenn Allen, a spokesman for the state’s insurance commissioner. Others include Aetna, Humana Inc. and Cigna Corp. No other company has yet told Georgia that it’s exiting, and companies have until May 11 to decide, he said.

UPDATE x2: OK, something strange going on here.

Last fall, I posted the following:

Health insurance startup joins Illinois market in flux

Chicago-area residents who buy health plans on the federal online insurance marketplace will see some new options for 2016 that are a sign of where health care is headed.

Insurance startup Harken Health will launch in Cook County on Nov. 1, when the Affordable Care Act's third open enrollment season begins, company executives told the Tribune in an exclusive interview. Harken will combine an insurance plan with its own medical clinics in a kind of holistic system that President Barack Obama's health care law encourages.

...Harken is a symbol of the changes. The company is an independently operated subsidiary of UnitedHealth Group, the nation's largest health insurer. UnitedHealth has taken a cautious approach to the Affordable Care Act, also known as Obamacare. It did not participate in the first year of the Illinois exchange in 2014 and this year offered individual plans only in Cook County. A company spokesman said UnitedHealth will offer plans in more Illinois counties in 2016 but declined further comment.

At the time, I thought that Harken Health was only operating in Illinois, but I noted that:

It's an interesting article in it's own right, discussing the "new type of insurance policy" etc etc...but the key point is this: Why is UnitedHealthcare scaring the crap out of everyone into thinking that they're gonna bail on the exchanges completely next year when they're simultaneously launching all-new subsidiary companies to sell policies on the exchange this year?

Again, perhaps there's nothing weird about this, but it sure sounds odd to me.

Well, it turns out that Harken Health is also operating in Georgia..and they're staying on the ACA exchanges there even though their parent brand is pulling up stakes (h/t to Phil Galewitz for the link):

Despite United’s decision to pull out of the Georgia exchange next year, Allen said Harken Health, an independent subsidiary of United, will be a participant.

Can any marketing or industry gurus explain this to me? I suppose they could be avoiding competing with themselves. To use an automotive analogy, I suppose this could be sort of like when Chrysler used to sell both the Dodge Colt and Plymouth Champ at the same time. They were both essentially the exact same car with different branding, marketed to different markets. If Chrysler decided to stop selling the Champ because it wasn't selling well to the family crowd but keep selling the Colt because it appealed to the "performance" market, it would be fair to say that Plymouth pulled out of that market, but it wouldn't be fair to say that Chrysler did, would it?

In this case, however, the analogy doesn't make much sense to me. As far as I know, health insurance carriers don't exactly have "image" branding (unless you're talking about new startups like Oscar Health, which is trying to brand itself as a "hip, with-it" insurance company). No one I know of gives a crap whether their health insurance company is "edgy" or "cool".

Besides, last fall UHC made it sound like they were losing money hand over fist in the exchanges. If the Harken model is successful, why not simply offer those policies under the parent brand? Or is the "UnitedHealthcare" brand really that disliked that they don't want anyone to know they're the parent company?

In any event, while the headline reads "UnitedHealthcare Pulls Out of Georgia!", the reality is that they aren't pulling out of Georgia...they're effectively just changing their branding of the products that are being offered in the state.

UPDATE x3: OK, it looks like I actually had the right idea (sort of) after all; thanks again to Zachery Tracer for pointing out this story from a few days ago (also by Phil Galewitz) about Harken:

UnitedHealth Tries Boutique-Style Health Plan

UnitedHealthcare is betting $65 million that it can profit by making primary care more attractive.

With little fanfare, the nation’s largest health insurer launched an independent subsidiary in January that offers unlimited free doctor visits and 24/7 access by phone. Every member gets a personal health coach to nudge them toward their goals, such as losing weight or exercising more. Mental health counseling is also provided, as are yoga and cooking classes, and acupuncture. Services are delivered in stylish clinics with hardwood floors and faux fireplaces in their lobbies.

Personal health coach? Yoga/cooking classes? Acupuncture? Hardwood floors? Lobby fireplaces?

For heaven's sake...this is effectively "Health insurance as an Apple Store". They really are going for a "lifestyle/branding" overhaul after all!

Harken Health is available only in Chicago and Atlanta, where it covers 35,000 members who signed up this winter on the Affordable Care Act’s insurance exchanges. UnitedHealth still sells traditional plans in those cities, too.

Harken’s lush operation might seem puzzling for a cost-conscious company such as UnitedHealthcare, which said in November it lost hundreds of millions of dollars on its Obamacare plans in 2015 andthreatened to drop out of the exchanges in 2017.

But it’s not crazy. Health care analysts say Harken demonstrates the insurer’s search for a better way to provide affordable care and attract more customers. Its mission is to prove that convenient, no-cost primary care, delivered with top-notch customer service, can lower hospitalization rates and overall health costs. Harken spends twice as much on primary care as the average insurer, according to the company.

“At the end of the day, United wants to know if this system can better control costs, as it’s a lot cheaper to prevent disease than treat one,” said Liz Frayer, an employee benefits consultant in Atlanta.

I actually applaud UnitedHealthcare for this move...but at the same time, it's irritating to already see headlines like this one which make it sound like the company is abandoning the exchanges in both states (this does appear to be the case in Arkansas, but again, it looks like they barely had any takers there to begin with).

UPDATE x4: OK, as pointed out in the comments, I guess it depends on your point of view. Harken is owned by UnitedHealthcare, but they're considered a completely separate company in terms of filings, networks and so forth. Plus, they're only available in the Chicago and Atlanta areas, so UHC is pulling out of most of each state. I've updated the headline (yet again) to reflect this.