Obamacare

Lashauna Butler, right, and Gloria Nunez, outreach and enrollment specialists with Community Healthnet, get ready to sign people up for the Obamacare health insurance marketplace in 2015 at Gary City Hall.

Dan Shelton, Times file photo

Most Northwest Indiana residents who get coverage on the Obamacare marketplace will have only one insurer to choose from next year.

Insurers announced their proposed rate hikes Thursday, a day after Anthem and MDWise said they were leaving the Indiana marketplace, also known as the exchange.

The only two insurers that will sell on Indiana's marketplace in 2018 will be Managed Health Services and CareSource. However, CareSource doesn't offer plans in Lake and Porter counties — it does in LaPorte County — and MHS currently doesn't contract with the Region's largest hospital system, Community Healthcare System.

"That's a killer, man. That's the cross of death, believe me," said Jeff Sopko, an insurance agent in Steger, Illinois, who sells to customers from Lake County. "That's going to hurt my customers. I've got at least 80 clients that have Anthem."

MHS and CareSource asked for rate increases, respectively, of 24 percent and 2 percent.

The announcement of the proposed rate increases comes the same day the U.S. Senate unveiled its plan to repeal and replace Obamacare. The 2010 law also known as the Affordable Care Act provides coverage to nearly 600,000 Hoosiers. About 175,000 get insurance on the marketplace — roughly 77,000 through either Anthem or MDWise — while about 423,000 are covered through the Healthy Indiana Plan, the state's Medicaid expansion.

The marketplace, found at HealthCare.gov, allows Hoosiers who earn between 100 percent and 400 percent of the federal poverty level and can't get coverage through an employer to buy government-subsidized insurance. In Northwest Indiana, enrollment numbers for the exchange are 12,106 in Lake County, 4,975 in Porter County and 3,008 in LaPorte County, according to the Department of Health and Human Services. 

The Senate is expected to vote on its bill, the Better Care Reconciliation Act, next week.

Uncertainty over the future of the exchange, along with fewer-than-expected signups, were reasons given by Anthem and MDWise for leaving the marketplace. Even if Obamacare remains, the Trump administration hasn't committed to keep funding cost-sharing subsidies or enforce the mandate that penalizes Americans who don't carry insurance.

"Any business operating in this environment would be considering similar moves," said Will Glaros, an employee benefits specialist in Schererville.

Politicians blamed colleagues in the opposing party for the insurers fleeing the Indiana exchange. For instance, U.S. Sen. Joe Donnelly, D-Ind., put responsibility for it on the Trump administration's "deliberate strategy" to undermine Obamacare, while U.S. Sen. Todd Young, R-Ind., said it highlighted the failures of the law and the need to take a different approach.

David Orentlicher, an Indiana University professor who specializes in health care law, said it's a shame to see the Indiana exchange crumbling because it had previously been successful. Indiana had been one of only two states to see a decline in average rates in 2017.

He said the exchange allowed people who didn't have employer-sponsored coverage to buy it at similar rates, enabling them to become entrepreneurs, go back to school, stay home to raise kids or retire early.

"It didn't matter if you worked for an employer with good health benefits," he said. "Now people will be more reluctant to start their own businesses, and that will be unfortunate."

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Giles is the health reporter for The Times, covering the business of health care as well as consumer and public health. He previously wrote about health for the Lawrence (Kansas) Journal-World. He is a graduate of Northern Illinois University.