With open enrollment for health plans under the Affordable Care Act now underway, 75,000 Wisconsin residents have been left looking for new coverage options following the exit of several major insurers from the exchange in 2018.
For Menasha-based Network Health, it’s provided an opportunity to court new members.
Network Health, a health insurance company owned by Glendale-based Ascension Wisconsin and Wauwatosa-based Froedtert Health, is one of three insurers to remain on the marketplace in Milwaukee County for 2018, along with Common Ground Healthcare Cooperative and Children’s Community Health Plan.
Citing the uncertainty of the unpredictable individual market, several major insurers decided to pull out of the exchange in Wisconsin, including Molina Healthcare Inc., Anthem Blue Cross and Blue Shield and Humana.
Coreen Dicus-Johnson, chief executive officer of Network Health, said many of the individuals affected by those insurers’ exists are patients of Froedtert Health and Ascension.
“The first and foremost reason we’re staying is because we’re a local community health insurer that is supported by two large provider systems,” Dicus-Johnson said. “And our ability to stay in the exchange is because of that integrated delivery system of provider and insurer that allows us to focus on the communities we’re supporting. It was a comprehensive, coordinated decision to be able to continue to support these communities.”
Given the current uncertainty of the federal subsidies promised to insurance companies under the ACA — which Dicus-Johnson said was a “cornerstone” of the health care law — Network Health’s decision to stay in the marketplace has the company weathering unpredictability.
“The federal policy that governs that line of business for us is a moving target, it’s shifting sands,” Dicus-Johnson said. “Promises that were made to insurers who entered into this line of business have not been kept.”
Still, Dicus-Johnson, who was previously president of Wheaton Franciscan’s central market before it merged with Ascension Health in 2016, said the company has long been working with Froedtert Health and Ascension to embrace more members.
“One of the benefits of being a provider-owned health plan is we have the ability to work incredibly collaboratively with our owners to solve issues about how do we continue to provide this access in a much more expeditious way,” she said.
Network Health offers health plans on the ACA exchange in eight Wisconsin counties, including Racine, Milwaukee, Ozaukee, Waukesha, Calumet, Outagamie, Winnebago and Washington.
