Apr 26, 2017

Anthem assumes ACA cost-sharing payments will be funded

Jacquelyn Martin / AP

Anthem CEO Joseph Swedish told investors Wednesday during the health insurer's first-quarter earnings call that the insurer will stay in the Affordable Care Act marketplaces for now, and that he expects Congress will fund the law's cost-sharing subsidies for low-income people. But Anthem, which has 1.6 million members with ACA-compliant health plans, also put Congress on the clock.

"We plan to file preliminary 2018 rates with the assumption that the cost-sharing reduction subsidies will be funded." — Anthem CEO Joseph Swedish.

The deadline: Early June. If Anthem doesn't find out about the cost-sharing subsidies by then, Swedish said Anthem will consider hiking premiums, reducing benefits or exiting some markets. Have fun, Congress.

Reminder the ACA is just a small slice of Anthem: The insurer posted a $1 billion profit in the first quarter on $22.3 billion of revenue and had 40.6 million health plan members — beating Wall Street's expectations. More than half of Anthem's revenue comes from Medicare and Medicaid.

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Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Axios Visuals

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Illustration: Sarah Grillo/Axios

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