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Amid loss of health insurers, Clayton-based Centene to enter Missouri exchange market

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Centene Corp. said Tuesday that it would expand into more Affordable Care Act insurance exchanges next year, offering coverage in Missouri, Kansas and Nevada.

The Clayton-based managed care provider also said it would expand its existing business in the states of Florida, Georgia, Indiana, Ohio, Texas and Washington.

The move comes as some major insurers have announced plans to withdraw from the exchanges in 2018, including Missouri’s, citing losses. Unlike those insurers, Centene has been able to thrive by piggybacking off its existing core business of providing health insurance to low-income individuals who qualify for Medicaid. At the end of March, Centene had 1.2 million Americans enrolled in exchange plans, almost all of whom are eligible for financial assistance.

“Centene recognizes there is uncertainty of new health care legislation, but we are well positioned to continue providing accessible, high quality and culturally sensitive health care services to our members,” Centene CEO Michael Neidorff said in a statement Tuesday.

Centene’s decision to expand in its home state follows a decision by Blue Cross Blue Shield of Kansas City to exit the market after sustaining losses. That departure could have left about 67,000 consumers in 25 western Missouri counties without an on-exchange insurer in 2018.

However, Centene is not disclosing the counties in which it will sell health plans.

“We are still working through the filing and review process, so we do not have specific details until the review is complete,” said Marcela Hawn, Centene spokeswoman.

“This could be a moment when one door closes and another opens. With a large part of Missouri at risk of having no insurer next year, Centene could see this as an opportunity,” said Cynthia Cox, a policy expert on the ACA’s effects on the private insurance market. Cox works for the Kaiser Family Foundation, a Menlo Park, Calif.-based nonprofit group that focuses on health policy.

“Of course, we don’t know yet which counties the insurer will enter, but it’s entirely possible Centene could fill the gap left by Blue Cross Blue Shield’s exit,” Cox said.

But there’s still concern more insurers may exit Missouri.

Anthem has yet to announce if it will continue to offer exchange plans in Missouri and 12 other states. Anthem said last week it would stop offering exchange plans in Ohio.

The exchanges, which consumers can access through the website, are a key part of the Affordable Care Act. They serve as an online marketplace to buy health insurance and qualify for financial assistance.

A series of actions by President Donald Trump’s administration have made insurers wary of the exchanges.

Chief among their concerns is an apparent reluctance by the administration to continue subsidies to help extend coverage to consumers with low incomes who probably could not otherwise afford coverage.

Trump also has repeatedly called for the replacement of the Affordable Care Act, saying the health law is in a “death spiral” and “imploding” and has thrown his support behind a Republican replacement bill, the American Health Care Act, which passed the House on May 4.

Republicans in the Senate are working on a version of the legislation, but are working in secret so few details are known. That’s drawn criticism from other lawmakers including Sen. Claire McCaskill, D-Mo., who demanded a hearing on the latest proposal during a Senate finance committee hearing Thursday.

“We have no idea what’s being proposed,” McCaskill said to Chairman Orrin Hatch, R-Utah. “There’s a group of guys in a back room somewhere that are making these decisions.”

“I mean, listen, this is hard to take.”

In a statement Tuesday, McCaskill applauded the Centene announcement, calling it “great news for many Missourians who’ll now have more choices for health insurance.” She said, though, that the continued uncertainty in the markets is “just unacceptable.”

Samantha Liss • 314-340-8017

@samanthann on Twitter

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