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Insurance Carrier Given OK To Expand Into All 82 Miss. Counties

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One of the health insurers offering coverage on the federal exchange in Mississippi has been given the green light to expand into all 82 counties, and officials hope the increased competition will help consumers.

Mississippi Insurance Commissioner Mike Chaney has approved the expansion of Magnolia Health Care’s Ambetter medical provider network in all counties next year. It currently operates in 50.

With United Health Care leaving the marketplace, Ambetter’s expansion means some counties will still have, or add, a second carrier.

Bob Williams is director of the life and health actuarial division at the Mississippi Insurance Department. He says that’s good news.

"It's always great to have choices," he says. "That's one of the things that the Commissioner is all about, consumers having choices. And so the fact that the counties will have choices of two carriers on the federal marketplace is a plus."

Williams says the Centers for Medicare and Medicaid Services had initially worried Ambetter didn’t have enough specialists in some counties.

"We found, knowing our state like we do, that the networks were adequate," he says. "What we knew, that CMS did not know, is that in certain counties that are more rural, you're not going to have specialists - they may be in the next county over."

Ambetter's expansion means there will be a second carrier, along with Humana, in 24 counties next year.

But the addition of a second carrier seems to have mixed results in practice. Ginni Tran is a community health worker and a certified marketplace navigator at Mercy Housing and Human Development in Gulfport. She says United joined Humana as a second carrier in Hancock County last year. Humana was a PPO, offering access to any doctors, and United offered an HMO, with more restrictions. So, she says, the prices of the more attractive Humana plan went way up.

"I thought having United Health Care in 2016 would drive the premiums down," she says. "But because they were such different plans - one was a PPO, one was an HMO - it changed the schematic completely to the opposite of what we thought was going to happen."

In 2017, Hancock should again have two carriers: Humana and, now, Ambetter.