Exchange Carrier Exits
Healthcare policy group KFF issued several issue briefers recently on carrier losses in the Exchanges.
The average number of issuers offering plans in the Exchanges has declined from 9.6 issuers per state in 2025 to 9.0 issuers per state in 2026. In total, 18 states experienced a net decrease in the number of issuers offering plans. Three in 10 counties have fewer participating insurers than last year. In 165 counties, only one issuer is offering plans, up from 93 counties in 2025.
Six carriers have announced that they will exit the Exchanges in 2027, either in some or all states that they are currently offering plans: Cigna Health, CareSource, PacificSource, Scott and White, Providence Health, and Taro Health.
In other news, Centene will offer buyouts to employees as it navigates a significant membership decline in both Medicaid and the Exchanges. During Q1, Centene reported a 6% decline in year-over-year membership to 26.3 million, driven largely by Exchange losses.
Additional articles: https://www.fiercehealthcare.com/payers/centene-offering-staff-buyouts-navigates-murky-aca-waters and https://www.modernhealthcare.com/insurance/mh-centene-buyouts-medicaid-aca-membership/ and https://www.beckerspayer.com/workforce/centene-offers-employee-buyouts/ and https://www.kff.org/affordable-care-act/tracking-insurer-participation-changes-in-the-aca-marketplaces-in-2027/
(Some articles may require a subscription.)
#exchanges #insurers #coverage #healthcare
Blues Performing Poorly
S&P Global Market Intelligence says nonprofit Blue Cross and Blue Shield health insurers underperformed relative to national and regional competitors last year. Only seven nonprofit Blues plans reported positive operating margins in 2025, one fewer than the prior year. Collectively, nonprofit Blue Cross and Blue Shield carriers reported a -2.4% operating margin.
(Article may require a subscription.)
#healthplans #blues #margins
https://www.modernhealthcare.com/insurance/mh-blue-cross-blue-shield-operating-margins-2025
State Directed Payments Flourish
Healthcare policy group KFF issued a series of briefers on state directed payments in Medicaid, which are set to take a major hit due to the passage of the One Big Beautiful Bill Act (OBBBA). Federal spending on directed payments is nearing $100 billion annually across 41 states. One of the briefs details all the changes in the OBBBA. Critics rightfully argue the prorgam has become unaccountable and is leading to a surge in spending.
Additional articles: https://www.kff.org/medicaid/federal-medicaid-spending-through-state-directed-payments-nears-100-billion-annually-across-41-states-with-new-limits-set-to-reduce-funding-to-states/ and https://www.kff.org/medicaid/forthcoming-policy-changes-to-medicaid-state-directed-payments/
#medicaid #spending #obbba
— Marc S. Ryan
