Two out-of-state health insurance companies have expressed interest in entering Louisiana’s individual exchange, a move that would reverse a trend of insurers leaving the market or consolidating in recent years.

Louisiana Insurance Commissioner Jim Donelon told a house panel this week policies from one of the insurers could be available as soon as Jan. 1 on the individual exchange, which was set up by the Affordable Care Act, commonly referred to as Obamacare, to provide coverage to people who don’t get health insurance from work, the government or other means.

Blue Cross of Louisiana and Vantage Health Plan were the only insurers offering policies on the exchange this year, after several insurers left in the years since the exchange was set up. But Blue Cross announced late last year it would acquire Vantage, making it the only company offering policies.

“The good news is since that merger of Blue Cross and Vantage, I have been visited by two out-of-state companies that have indicated to me they want to be on the exchange Jan. 1 offering individual policies,” Donelon told the House Appropriations Committee, which was hearing an update on his budget.

It’s not clear who the insurers are. Donelon said one of them ran into “provider-network” problems and likely won’t be ready to offer policies by January, while the other is expected to start offering plans in one-third to one-half of the state’s ZIP codes by then.

Donelon spokesman John Tobler said there are “positive signs for the future competitiveness of the market going forward.”

The agency said it will have a better idea of whether the 2020 start date is feasible in the coming months.

The individual exchange saw its lowest enrollment on record this year. Officials pointed to Medicaid expansion and a growing economy, which is funneling more people into employer-sponsored health insurance.

For the first time this year, the individual market also saw a decrease in premiums, following years of rate hikes. Most people on the exchange get government subsidies to offset the costs.

Tobler said the instability of the ACA in recent years has led insurers to leave, especially after programs like market stabilization subsidies expired.

Premiums dropped by 6.4 percent in the exchange in 2019, after rising by 18.5 percent in 2018. Blue Cross and Vantage both lowered rates after posting a profit the year before.

The Trump administration has tried to undermine the individual exchanges, expanding access to things like short-term plans and association health plans that can offer skimpier coverage for less money. Congressional Republicans and the Trump administration also repealed the penalty on people who choose not to buy insurance, though Louisiana’s navigator organization recently said that hasn’t caused an exodus from the market.

Donelon is backing a bill this legislative session that would replace the Affordable Care Act with a statewide law that has many of the ACA's same components. The state law would only go into effect if the ACA is repealed at the federal level. 

Louisiana Attorney General Jeff Landry is currently part of a lawsuit brought by several state attorneys general, and backed by the Trump administration, seeking to repeal the ACA.

Landry also supports the Louisiana ACA replacement bill, which is being carried by state Sen. Fred Mills. Gov. John Bel Edwards is backing a similar bill this session.

Blue Cross spokeswoman Cindy Wakefield said the acquisition of Vantage has not closed yet, and the insurer does not have a timeline. 

Follow Sam Karlin on Twitter, @samkarlin.