PPO Health Plans Disappearing from Public Health Exchanges

Preferred provider organization health care plans are disappearing from public health insurance exchanges established under the federal health care reform law, a new study by the nonprofit Robert Wood Johnson Foundation shows.

Two-thirds of the 131 insurers that offered silver-level PPO health plans through the public exchanges in 2015 dropped or reduced the number of plans offered for the 2016 plan year, according to a report published by the Johnson Foundation on Wednesday.

Among the top 25 insurers offering PPO plans through the exchanges in 2015, only five maintained all of their plan offerings for 2016, according to the report.

“Carriers who discontinued PPOs have argued their expense makes it impossible to affordably price exchange products,” Katherine Hempstead, director and senior program officer at the Johnson Foundation in Princeton, New Jersey, wrote in the report. “It remains to be seen how marketplace consumers will react to these trends, and to what extent these changes in plan design will also be seen in the off-exchange market and in employer-sponsored coverage.”

The reduction in PPO plans available through public exchanges was most prevalent in the Southwestern and Southeastern regions, where only 8% and 20% of insurers maintained all of their 2015 exchange-based PPO offerings for the upcoming plan year. Insurers dropped the entirety of their PPO offerings in Florida, Iowa, Indiana, New Mexico, Nevada, South Carolina, Texas and Utah.

Insurers offering PPO plans through public exchanges in the Northeastern, Mid-Atlantic, Pacific and upper Midwestern regions were least likely to drop those plans for 2016, but most likely to reduce the number of plans offered, according to the report.

  

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