Centene to expand health insurance exchange offerings in 15 states

Last modified September 11, 2020. Published September 11, 2020.

Corporation, the largest provider of Health Insurance Marketplace plans, said Friday that it intends to grow its presence on the exchanges in 2021 by increasing the availability of its marketplace product suite in more than a dozen states.

The Missouri-based insurer plans to expand the distribution of its marketplace product, Ambetter, across nearly 400 counties in 13 states in which it is already active. Ambetter will also expand into two new states, New Mexico and Michigan.

Under the Affordable Care Act, people seeking health insurance can purchase plans through a state or federal marketplace, also known as an exchange. People in most states enroll through HealthCare.gov, but a dozen states and the District of Columbia have their own websites for enrollment.

Centene maintains that the coverage it offers through the marketplace is designed to be affordable for lower-income people and families who may not qualify for Medicaid or other government coverage.

Ambetter plans are currently available in Arkansas, Indiana, Mississippi, Nevada, New Hampshire; in parts of Arizona, Kansas, Missouri, Florida, Georgia, North Carolina, South Carolina, Ohio, Tennessee, Texas and Washington; and in the Chicago and Philadelphia areas.

Centene says that about 2.2 million marketplace members are enrolled in its plans. 

But Obamacare has not been an unqualified boon for the company. In August, a federal jury in Little Rock, Arkansas, awarded $9.4 million to Southeast Emergency Physicians, an Arkansas-based group of about 175 emergency-room doctors, nurse practitioners and physicians assistants who contended that they had been underpaid by a Centene subsidiary, the Arkansas Democrat-Gazette reported. Centene contended that when the Affordable Care Act took effect, a 2011 contract between the physicians group and the insurance company no longer applied, but the jury determined that the contract applied to a new insurance product introduced in 2014, and that Centene breached the contract by paying the doctors 10%, instead of 75%, of regular commercial billing rates, the paper said.

Center for Medicare and Medicaid Services report released in April 2020 said that about 11.4 million people enrolled or were automatically re-enrolled in a marketplace plan in 2019 for 2020 coverage. Enrollment for 2021 coverage will begin Nov. 1, 2020, and run through Dec. 15.