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Cigna expands Affordable Care Act plans in 19 markets across 10 states

The expansion into the ACA for Cigna and other insurers comes at a time when CMS reports declining unsubsidized enrollment.

Susan Morse, Managing Editor

Cigna is expanding its offerings on the Affordable Care Act, moving into 19 markets across 10 states. 

This includes expansion into select counties in Kansas, South Florida and Utah as well as new counties in Tennessee and Virginia.

Cigna is offering preventive care at zero cost to consumers; 24/7 customer service, wellness and benefit resources; savings on gym memberships and nutrition services; plus increased access to $25 out-of-pocket caps on 30-day supplies of insulin. 

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Cigna's plans on the individual exchanges will include expanded online access to doctors through Cigna's telehealth service at no additional cost.

Open enrollment begins November 1 and ends December 15.


Cigna and other insurers are expanding their footprint in the ACA market at a time when the Centers for Medicare and Medicaid Services reports enrollment is down among consumers who do not qualify for tax subsidies.

CMS linked the decline to affordability issues.


In its seventh year, the ACA shows signs of growing stability, as measured by moderate premium increases and increased participation by health plans, according to the The Robert Wood Johnson Foundation in a report released Wednesday.

In 2019 there was some modest entry, mostly by the Medicaid Managed Managed Care Organizations, but also by a few new national carriers, including Oscar and Bright Health.

Some of the states with the most uncompetitive markets saw improvement. For example, Iowa's Blue plan returned to the marketplace, and Medica entered the entire state of Oklahoma.

Large margins, as seen in recently released medical loss ratio rebate figures, attracted additional entry, the report said.

For 2020, the trend toward greater issuer participation has continued. Centene, Oscar, and Bright Health have announced large expansions. A few Blue plans have increased their territory, along with Anthem.

For Blue and regional carriers, issuer presence in 2020 is close to what it was in 2015, and has not changed all that much in the intervening years. On the other hand, the ACA Co-ops are essentially gone. For national carriers, there has been a huge retreat. Major players like Humana, Aetna, and United, are either completely or almost completely out of the market.

The MMCO category is the only one for which market participation has grown every year, and Centene has become the largest single issuer in the marketplace, the report said.

CMS said in its August report that enrollment has remained largely unchanged since 2017 while affordability continues to be problematic for those without tax subsidies.

Enrollment on the exchanges remained steady in both 2018 and 2019, while average 2019 premiums declined by a small amount.

In the space of two years, between 2016 and 2018, 2.5 million unsubsidized people left the market, a 40 percent drop, CMS said.

CMS Administrator Seema Verma said, "As President Trump predicted, people are fleeing the individual market."

Yet Verma said during 2019 enrollment that part of the reason for the decline was a low unemployment rate, with more individuals being covered under their employers' insurance plan.

The report shows that 2018 average monthly enrollment through the exchanges increased by 1% over 2017, while the early 2019 data shows that 10.6 million consumers had effectuated coverage in February 2019--about one percent lower than at the same time last year.

The report also shows that the average total monthly premium for exchange enrollees in February 2019 decreased by 1% from the prior year.

The Trump Administration reduced the user fee charged to issuers beginning with the 2020 plan year, a reduction that will be passed on to consumers in the form of lower premiums next year, CMS said.


"All of the services and support that we are able to provide our customers is only possible with the close and collaborative relationship that we have with our physician partners across the country," said Lisa Lough, general manager of Cigna's individual and family plans business. "It is in partnering with these physicians, many of whom are in value-based care arrangements, that we are able to help our customers enjoy healthier and more productive lives."

Twitter: @SusanJMorse
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