Maybe it's the wheat.
Maybe it's Topeka and Wichita and Overland Park.
Maybe it's a little insurance market magic from Kathleen Sebelius, the former Kansas insurance commissioner and federal health official who helped implement the Affordable Care Act.
Whatever the reason, the Kansas health exchange in 2017 likely will have new competitors in the form of a division of Connecticut-based Aetna as well as Minnetonka-based Medica. We reported on the development in today's Star Tribune.
Why should you care?
This is another (small) chapter in the ongoing saga of whether the exchanges will succeed or fail.
For months, the narrative has been dominated by UnitedHealthcare, which is exiting next year some two dozen exchanges including the government-run marketplace for Kansas. United said it was losing too much money on the exchanges, and the pullback has been cast by some as the clearest symptom of long-term woes for the health law.
In the short-term, United's departure is hitting hard in certain states like Kansas that otherwise lack much insurance competition.
The gloominess at United is shared to varying degrees by other insurers, but none of the other national players have staged such a large retreat. Aetna's move in Kansas, in fact, fits with a somewhat positive message the insurer sent this week about the future of the exchanges.
Of course, when it comes to the health law, you never have to look far for conflicting sentiments.
On Thursday, a federal judge handed a victory to House Republicans in their legal challenge to "cost-sharing reductions" for many who buy coverage under the health law. The legal fight isn't over yet.
Iowa is another state that's losing UnitedHealthcare on the exchange next year, a loss that's mitigated by the fact that the state's dominant Blue Cross plan will be joining the marketplace. But this week the Des Moines Register reported that Wellmark Blue Cross and Blue Shield is planning big rate hikes in the non-exchange portion of the state's individual market.
What will Iowa exchange rates look like? Stay tuned.