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An opioid epidemic. High smoking rates. Health care provider shortages. Indiana faces serious public health challenges. Side Effects Public Media provides in-depth coverage of these issues and more.

Two Indiana Insurers Left Standing On Exchange

Only two health insurers will offer plans next year on Indiana’s Affordable Care Act exchange, according to proposed rate increases posted by the Indiana Department of Insurance posted Thursday. That’s down from four insurers this year and seven in 2016.

Insurers CareSource and MHS Indiana requested rate increases of 2 and 24 percent respectively. 

The two companies are all that remain in the exchange after Anthem and MDwise announced Wednesday they had decided to drop their Indiana exchange plans, citing regulatory uncertainty.

John Holahan of the Urban Institute says several insurers across the country have left the marketplace. That’s thanks, he says, to the federal government’s hemming and hawing over the future of federal payouts to companies called cost-sharing reductions. CSRs reimburse insurers for providing premium assistance to customers on the exchange.

Holahan says insurers are preparing for the chance the government might not pay them:

If you price too high, you’ll lose market share, so you’ve got to find that sweet spot where you’re pricing  adequately to cover the risk but not too high so that someone can underbid you,” he says.

CareSource estimates an average monthly premium of $424. MHS pegs their average premium at $452.

“What we do know is the uncertainty because of the current administration being vague and vacillating on what they're going to do about funding the cost-sharing subsidies, to the extent insurers are worried about that, they'll load the expected impact of this into their premiums,” says Holahan.

Indiana has until recently escaped the fate of several states risking “bare counties” which have only a single insurer. According to the Kaiser Family Foundation, in 2017 all Indiana counties had at least two insurers offering marketplace plans.

The state will finalize the rate proposals this fall.

This story was produced by Side Effects Public Media, a reporting collaborative focused on public health.