Dive Brief:
- Cigna will offer Affordable Care Act marketplace plans in two fewer states in 2024 after expanding its presence on the exchanges last year.
- The insurer will exit the Missouri and Kansas markets for the 2024 plan year, as well as two counties in Arizona and two counties in Utah, according to a Cigna spokesperson. Next year, Cigna will offer health plans in 14 states, including adding coverage in 15 counties in North Carolina.
- A company spokesperson said Cigna wasn’t able to offer plans that met its standards for high quality care, health outcomes and value to its customers “at an affordable price” in the markets it was exiting.
Dive Insight:
A record-breaking 16.3 million people signed up for marketplace plans in 2023, boosted by extended pandemic-era subsidies that protected enrollees from premium hikes, according to the CMS.
But insurers say inflation is increasing the cost for medical care and prescription drugs, and they’re requesting a median 6% premium increase next year in a survey from KFF. Though many enrollees receive subsidies and won’t see extra costs, premium increases could grow federal spending on subsidies, according to the report.
Cigna expanded its marketplace offerings for 2023, adding plans in Texas, Indiana and South Carolina.
During open enrollment, which begins in November, Cigna will offer marketplace plans in 350 counties across Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Utah and Virginia.
“We remain committed to growing our presence in the ACA Marketplace in areas where we are confident we can offer high-quality, affordable healthcare, and to improving the health and vitality of those who depend on it for their coverage needs,” a Cigna spokesperson told Healthcare Dive.
The insurer’s medical loss ratio, or how much of the premium is spent on patient care, was 81.2% in the second quarter this year, better than analysts predicted after some insurers raised red flags about higher-than-expected utilization.
But on an earnings call, CEO David Cordani said Cigna’s medical costs were hit by higher estimated risk-adjustment payments in the ACA individual exchanges in two states. The insurer filed for “sizable” rate increases in those two states for 2024, he said.
