JACKSON, Miss. — All Mississippians will have at least one insurance option on the new federal online marketplace when it starts enrolling customers in October.
Humana, based in Louisville, Ky., announced Friday that it would cover people in the 36 Mississippi counties where no insurer had agreed to write policies. Coverage under those policies begins Jan. 1.
"This builds on Humana's current presence," the company said in a statement. "By working together with local health care providers, we believe we can enhance quality of care and improve health outcomes in the state."
Of states where insurers had been announced for exchanges, Mississippi had been the only one with areas that no insurer had filed to serve. That coverage void had prompted concern among some state and federal officials.
"They're good corporate citizens, and there's money to be made," state Insurance Commissioner Mike Chaney said of Humana. He said a number of people had worked together to persuade the company to step forward.
Magnolia Health Plan, a unit of St. Louis-based Centene Corp., has said it will serve 46 counties, including the four that Humana had already designated. Centene already runs a Mississippi Medicaid network with 77,000 enrollees.
Until Friday, insurers had announced plans to cover 46 of the state's 82 counties. Humana had previously said it would cover people in four urban counties — Hinds, Madison, Rankin and DeSoto, overlapping with Centene. For now, only residents of those counties will have more than one choice.
"The exchange is meant to be a free, open marketplace that encourages competition and innovation, so naturally we're going to need more than one carrier," said Roy Mitchell, executive director of the Mississippi Health Advocacy Program.
Areas that will gain coverage because of Humana's announcement include swaths of the Delta region and southwest Mississippi, plus scattered areas elsewhere. Among those areas are Corinth, Greenville, Laurel, Natchez and Picayune. The Center for Mississippi Health Policy estimated that 54,000 uninsured adults could be eligible to buy policies through the exchange in the counties in question.
"It really does make a difference to have at least one company for those counties," said Therese Hanna, the policy center's executive director.
Chaney credited Gary Cohen, the U.S. Centers for Medicare and Medicaid Services' deputy administrator, for bending the rules to allow Humana to extend coverage after the deadline to file. Cohen's office declined comment, but CMS officials had repeatedly said they were concerned about the gaps in coverage in Mississippi.
"They were under a lot of pressure to say what was going to happen with Mississippi," Mitchell said.
U.S. Rep. Bennie Thompson, a Bolton Democrat, praised Humana.
"Each Mississippian deserves quality, affordable and accessible health care coverage," Thompson said in a statement. "I urge other insurance companies to follow Humana's lead in offering affordable health insurance options to Mississippians."
The state's two largest private insurers, Flowood-based Blue Cross & Blue Shield of Mississippi and UnitedHealth Group of Minnetonka, Minn., have declined to offer plans in the online marketplace.
People with incomes between 133 percent and 400 percent of the federal poverty level will be eligible for federal tax credits, on a sliding scale, to help pay for coverage in the online marketplace. That's income of up to $46,000 for an individual and $94,000 for a family of four, with those at the top getting little or no subsidy.
The policy center projected in 2012 that 275,000 Mississippians could gain insurance through exchanges, with 230,000 benefiting from federal tax credits that could total $900 million a year.
The marketplace program is separate from proposals to expand the state-federal Medicaid program to cover people with incomes up to 138 percent of poverty. Mississippi has declined to extend Medicaid.
In February, the federal government rejected Chaney's effort to create a state-based exchange in Mississippi because of opposition by fellow Republican Gov. Phil Bryant. That means Mississippi's market will be run by the federal government.
Because Mississippi is a small, poor state with relatively few insurers, there wasn't a flood of new entries. Any new insurer would have to try to sign up a network of doctors and hospitals, and could have a hard time negotiating favorable payment rates because it would have few customers at the beginning. That's not a problem for Humana, though, which handles insurance for military retirees, employer groups and Medicare beneficiaries. The company said it already covers more than 200,000 Mississippians.
Chaney said participation in the marketplace could help Humana build up business in the state, especially in the commercial market where it competes against Blue Cross.