Molina and Centene Announcements May Boost ACA Exchange System

News June 18, 2018 at 07:35 PM
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2019 (Image: Allison Bell/TA)

Officials in Florida and New York state have made moves that could help shore up part of the Affordable Care Act public exchange system in 2019.

The Florida Agency for Health Care Administration has awarded Medicaid managed care contracts in two regions to a Florida-based unit of Molina Healthcare Inc.

In New York state, the New York attorney general has approved efforts by Centene Corp. to acquire the assets of New York State Catholic Health Plan Inc., which does business as Fidelis Care.

Molina is a publicly traded insurer based in Long Beach, California, that has focused on the Medicaid plan market. The company has offered ACA public exchange plans in most of the states in which it offers managed Medicaid plan coverage, in an effort to provide coverage suitable for people who bounce back and forth between qualifying for Medicaid and qualifying for highly subsidized ACA public exchange plan coverage.

Centene is a St. Louis-based company that has also focused on the Medicaid plan market. Like Molina, it has been an active player in both the Medicaid plan and the ACA public exchange plan markets.

Florida has had more ACA exchange plan enrollees than any other states, but it has had only one or two carriers in most counties.

Molina executives said in May, during a conference call with securities analyst, that the company might withdraw from the Florida ACA exchange program if the company lost the ability to sell managed Medicaid plans in Florida.

Molina says it now has the rights to offer managed Medicaid plans into the Florida Medicaid region that includes Sarasota, and in the Florida Medicaid region that includes Miami.

The contract starts Jan. 1, 2019.

Molina now has about 105,000 Medicaid plan enrollees in those regions.

In New York state, the ACA public exchange program has attracted many issuers.

But Centene's move to acquire Fidelis, through a deal with a value of $3.75 billion, could help increase  the odds that Fidelis Care will be vigorous player in the New York state individual major medical market, as well as the state's managed Medicaid plan market, in 2019.

Centene says it plans to close on the Fidelis Care acquisition July 1.

The individual major medical open enrollment period for 2019 is set to start Nov. 1 and end Dec. 15.

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