Cigna expanding ACA footprint to 3 new states in 2023

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Dive Brief:

  • Cigna is expanding its Affordable Care Act market presence next year, a little over a week since President Joe Biden signed a law extending subsidies for coverage and subsequently creating more stability in the exchanges.
  • Cigna health plans will be available on the individual exchanges in three new states — Texas, Indiana and South Carolina — and 50 new counties in the existing markets of Georgia, Mississippi and North Carolina in 2023, the payer said Monday.
  • Cigna is expanding into geographic areas where it has strong provider partnerships, with a majority of anchor providers in value-based arrangements, the company told Healthcare Dive.

Dive Insight:

Pending regulatory approvals, Cigna will next year offer individual and family plans on the ACA exchanges in 363 counties spanning 16 states. The new markets have the potential to reach roughly 730,000 additional customers, the Connecticut-based payer said.

Health insurers have been racing to ramp up their ACA offerings as enrollment in the exchanges swells, spurred by financial incentives, COVID-19 special enrollment periods and economic uncertainty destabilizing job-based coverage. A record 14.5 million Americans signed up for ACA plans for 2022, the highest volume since the law was signed 12 years ago.

In addition, the Inflation Reduction Act passed earlier this month extends subsidies for millions of Americans in the exchanges. Passage of the $740 billion, Democrat-backed package is good news for patients who buy coverage in the exchanges, but also for the health insurers that sell it, as extending the premium assistance should result in less churn on rolls and more stable revenues.

A number of payers including Cigna, UnitedHealthcare and CVS expanded their ACA footprints for coverage for 2022.

And earlier this month, CVS announced it planned to expand its ACA footprint to four new states in 2023, a year after its payer business Aetna said it would return to the exchanges after exiting them in 2017.

Cigna’s new plan features include access to a virtual primary care network via MDLive, a telehealth provider acquired by Cigna’s health services arm Evernorth last spring. Plans also have $0 to $3 co-pays for preferred generic medications and access to a program that caps insulin costs at $25 per month.