UnitedHealthcare to sell individual health plans in Wisconsin, three other states

UnitedHealthcare plans to sell coverage on the individual health insurance market in four more states next year, expanding its return to government-run health exchanges.

Currently, the Minnetonka-based health insurer sells health plans for individuals on public-run exchanges — also known as "marketplaces" — in 22 states. With regulatory approval, the company will add New Jersey, New Mexico, South Carolina and Wisconsin.

UnitedHealthcare does not sell individual market plans on MNsure, which is Minnesota's government-run marketplace. It wasn't clear Monday how close the Wisconsin coverage would come to Minnesota's border — more details should be available by month's end, according to a company spokesman.

"For 2024, we are seeing some new marketplace entrants and expansions," said Krutika Amin, a researcher with KFF, a California-based health policy group. "The number of insurers stayed about the same from 2022 to 2023 nationally on average."

Individual market enrollment contracted from 2017 to 2019 amid steep premium increases, particularly among people not receiving subsidies, but has been growing since 2020, according to an analysis from KFF. As of early 2023, an estimated 18.2 million people had individual market coverage, the group says, the highest enrollment total since 2016.

Insurers may see the chance for growth in the individual market as states have resumed checking eligibility for coverage among Medicaid enrollees, Amin said. Some covered through the state-federal health insurance program during the height of the COVID-19 pandemic might now make too much money to qualify.

In Minnesota, for example, the state has identified more than 9,000 people who no longer qualify for Medicaid benefits and have been referred to the MNsure exchange to explore private health insurance options.

"There are still others uninsured," Amin said, "who are eligible for marketplace subsidies."

Beginning in 2014, the federal Affordable Care Act brought sweeping changes to the individual market, which is designed for people under age 65 who are self-employed or don't get health plan benefits from their employer.

The law created health exchange marketplaces where consumers tap federal tax credits to discount their out-of-pocket premium costs. It also imposed requirements for comprehensive benefits.

UnitedHealthcare, which is one of the nation's largest health insurers, startled the market in November 2015 by saying it couldn't continue to subsidize large losses on coverage for individuals. The company went from selling individual health plans in 33 states during 2016 to just five states in 2017 — then dropping to just two states in 2018.

Marcus Robinson, president of UnitedHealthcare's individual market business, said Monday in a statement: "We believe everyone should have access to health coverage and will be offering affordable individual and family plans on the marketplace to meet the needs of more consumers and their families."

Across the country, premiums are on the rise in the individual market. Minnesota announced last week that premiums on health insurance policies sold to individuals in the state will increase on average between 1.9% and 5.5% next year — more than increases for 2023. About 110,000 people buy coverage through MNsure.