Optima Pulls Out of Rural Virginia, Leaving 62,000 Marketplace Enrollees Without Insurance Options

Sep 7, 2017

This week, yet another insurer pulled out of the marketplace for subsidized health insurance created by the Affordable Care Act. As Michael Pope reports, this announcement has more drastic consequences than the previous ones.

Last month, it looked like Virginia’s marketplace of health-insurance providers for low-income people would actually be expanding — providing more choices to more people. But then the largest provider, Anthem, decided to pull out. Jill Hanken at the Virginia Poverty Law Center says that set into motion a chain reaction that had Optima reversing a decision it made only a few weeks ago to expand into all those rural Virginia; areas that were served by Anthem.

“When Optima made its decision to expand to more localities in Virginia, it was at the time that Anthem was also serving that population. But when Anthem pulled out, it left Optima holding the bag. And the bag was an enormous bag.”

Credit Optima Health

A bag full of sick patients to insure. In most businesses, setting up a monopoly would be a good thing. But Sabrina Corlette at Georgetown University says health insurance doesn’t work that way.

“We just nationally celebrated a couple of weeks ago that the last county in the country that was without an insurer – that was in Ohio – was filled just last month. So hearing about this news in Virginia, it sounds like a real setback.”

A setback especially for the 62,000 people with marketplace insurance who live in one of the 63 localities in Virginia that now have no option for health insurance. Open-enrollment for places where the insurers haven’t bailed yet starts in November.

This report, provided by Virginia Public Radio, was made possible with support from the Virginia Education Association.