UPDATE: Anthem spells it out as clearly as they possibly can: A story in 4 tweets

UPDATE: Note that Anthem made these statements BEFORE Molina drew their line in the sand re. CSR payments. That could be a game changer.

I'll let Tami Luhby of CNN/Money take the floor:

Anthem says Obamacare business doing 'significantly better,' but still may exit some areas. https://t.co/ToFAvXj62t via @CNNMoney @luhby

— Tami Luhby (@Luhby) April 26, 2017

$antm CEO: "Individual business is doing markedly better than last year." But claims are slightly higher than expected.

— Tami Luhby (@Luhby) April 26, 2017

$antm CEO: If no certainty on cost-sharing subsidies by early June, insurer may have to raise rates further or withdraw/exit Obamacare.

— Tami Luhby (@Luhby) April 26, 2017

$ANTM CEO: Obamacare rates could rise 20% or more if Congress doesn't fund cost-sharing subsidies.

— Tami Luhby (@Luhby) April 26, 2017

OK, her full story includes a few more details:

The company, which has 1.1 million members on the Obamacare exchanges, said its individual market segment is doing "significantly better" than last year. Although it said claims still ran slightly higher than expected.

"All-in all, the individual business started out 2017 significantly better than it started out 2016," said Anthem CFO John Gallina. "However, [it remained] a little bit behind our expectations."

...Gallina noted that the company has said it expects its individual market to break even or be slightly profitable in 2017.

...Anthem (ANTX), however, said it is still assessing its participation and premiums for 2018.

...Anthem is one of the largest players on the Obamacare exchanges. If it were to pull out, some 256,000 people in Georgia, Kentucky, Missouri, Ohio and Virginia would be left with no options -- unless another carrier steps in.

...However, Anthem stressed that the uncertainty around the cost-sharing reduction subsidies -- which reduce deductibles and co-pays for lower-income Americans -- is still a big issue.

...Anthem will file its rates with state regulators in coming weeks assuming the subsidies will be funded, Swedish said. However, if there is no decision by early June, it will have to reassess those premiums and its participation.

Eliminating the subsidy funding could hike premiums by 20% or more next year, the company said.

In other words, exactly what I've been saying for months now: Many/most of the carriers appear to finally be over the hump and want to stick around with fairly reasonable rate hikes (relatively speaking), but if Trump/the GOP keeps farting around and/or sabotaging the exchanges, they'll either bail or jack rates up dramatically.

Other tidbits to note:

  • 1.1 million ACA exchange enrollees as of 3/31, vs. 1.2 million for Centene
  • Both the Kaiser Family Foundation and the American Academy of Actuaries seem to have hit the "no CSR" nail on the head: 20% hikes due specifically to that factor.

UPDATE: From the actual earnings call transcript:

In the Individual business, enrollment increased by 222,000 lives, and we ended the quarter with nearly 1.6 million ACA-compliant members with 1.1 million of those members on the individual exchanges. The remaining, approximately 300,000 members, are in non-ACA compliant grandmothered or grandfathered plans, which continues to decline as expected, a decline of a little less than 100,000 since the prior-year quarter.


  • 1.9 million total individual market enrollees
  • 1.1 million exchange enrollees (58%)
  • 500K off-exchange (ACA compliant) (26%)
  • 300K grandfathered/grandmothered (16%)
  • grandfathered/grandmothered down about 25% year over year