Medica is seeking regulator approval to expand the number of Wisconsin counties where it sells individual market coverage.
It’s another example of how the Minnetonka-based insurer seems to be bucking the national trend of insurers pulling back from markets under the federal Affordable Care Act (ACA).
In Wisconsin, Medica said it wants to grow its individual market business from 13 to 21 counties through a health plan that includes Mayo Clinic Health System as a preferred provider.
In recent weeks, Medica filed for approval to sell individual market coverage statewide for 2018 in Iowa, Kansas and Nebraska — states where other health plans have withdrawn due to financial losses.
“With today’s announcement, Medica has signaled its intention to increase its footprint in Wisconsin by eight counties,” the insurer said in a statement Monday.
The individual market is the source of health insurance primarily for people under age 65 who are self-employed or don’t get health insurance through their employer or a government program.
The ACA brought sweeping reforms to the market in 2014, but insurers have found it difficult to make the business profitable. Several health plans have dropped out of markets, as a result, with Medica at one point looking like it might be the only insurer that would return statewide next year to Iowa and Nebraska plus a portion of Kansas.
The competitive landscape in these states is in flux, however, with some insurers now signaling they might compete. In Iowa, for example, the state’s dominant Blue Cross and Blue Shield insurer has said it might return to the individual market for 2018 if the federal government grants a waiver that would allow for certain regulatory changes.