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May 02, 2018 at 12:04 PM
One of the Medicaid plan companies that has been a major player in the Affordable Care Act public exchange plan market could pull out of Florida in 2019.
Executives from the insurer, Molina Healthcare Inc., said Monday that the company will have to think about its ACA exchange presence in Florida and New Mexico, now that it appears to be on track to lose the ability to sell coverage through those states’ managed Medicaid programs.
“We are obviously in the process of developing our preliminary rate bids, which go out in early June,” Joe Zubretsky, Molina’s president, said during conference call with securities analysts. “We have decisions to make in Florida and New Mexico. If we lose our Medicaid contracts there, [ACA] marketplace will be the only substantial business we have in those markets.”
(Related: New ACA Risk Report Hits Some Health Insurers With Huge Bills)
Molina had been hoping to win a contract to participate in at least one region in Florida, but Florida rejected its bid, Zubretsky said.
Molina is still appealing the rejection.
Molina may have lost in Florida partly because rapid growth in the company’s ACA exchange plan enrollment in Florida led to complaints about service in Florida, Zubretsky said.
Molina could still return to the Florida ACA exchange program in 2019, however, because efforts to increase premiums and reduce costs have paid off their, and the Florida exchange plan operation appears to be doing better, Zubretsky said.
Zubretsky said, however, that one problem with the ACA exchange program is that benefits ratios tend to be very low in the first quarter, because of the way deductibles and other coverage provisions are designed, and predicting what the claims will be like later in the year is difficult.
