Kentucky: Anthem bails on half the state, cites CSR as major cause

Yesterday saw two ugly setbacks for the ACA in Virginia and Kentucky. First, Optima announced that they were pulling out of about half the counties in the state and is resubmitting much higher rates for the other half, in large part due to the failure of the Trump Administration and the GOP Congress to commit to making CSR reimbursement payments next year. This also leaves 63 Virginia counties in jeopardy of "going bare" without any individual market carriers whatsoever.

At the same time, Anthem Health Plans of Kentucky announced that they, too, are dropping out of half of that state...once again pinning much of the blame on the CSR issue specifically:

Anthem on Wednesday continued reducing its Obamacare business, as the big insurer said it will cut in half the number of counties in Kentucky where it sells individual health plans next year.

Anthem's decision to sell individual plans in just 59 counties in Kentucky comes more than two months after the Blue Cross Blue Shield insurer filed proposed rates for health plans in 2018 for all 120 counties in the state.

...The insurer, as it has done with previously announced pullbacks from Obamacare marketplaces in other states, on Wednesday cited an individual health plan market that "remains volatile" as it disclosed its cuts in Kentucky.

...Anthem also blamed uncertainty over whether insurers will be guaranteed payments by the federal government that compensate them for offering lower-income Obamacare customers discounts on out-of-pocket health costs.

The Trump administration has threatened to end those cost-sharing reduction payments.

I'm not sure how many current enrollees this will impact. Anthem has around 70,000 indy market enrollees in Kentucky; assuming that's proportional statewide, that would mean roughly 35,000 people who will have to switch over to CareSource (thankfully, unlike in Virginia, Anthem's move doesn't open up any more "bare" counties). If so, that changes Kentucky's Requested Rate Hike summary to look something like this: