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BC of TN pulling out of ACA in major cities
Old 10-11-2016, 07:51 AM   #1
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BC of TN pulling out of ACA in major cities

Looks like Blue Cross of TN will be pulling out of the major cities in Tennessee for 2017. It shows Market Place/Individual Plans so you will not be able to continue with BC if you live in certain counties.

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Old 10-11-2016, 08:11 AM   #2
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Thanks for the link. I'm not covered by these plans but have been interested in why companies are backing out in so many places. These are points I gathered from the website Q&A on why they are making the change (my summary, not direct quotes):

- BlueCross (BC) is a non profit but targets a 2-3% net profit to avoid eating into their reserves too much. So profitability is not a big driver for them...only not having losses.

- By end of 2016, they have losses approaching $500M. (I assume this means losses even after assistance by the government for the transition time. I think 2016 is the last year for assistance? Not stated if this is for 2016 or total since beginning of ACA entry.)

- They are raising rates but don't feel comfortable enough with the program's near future to keep risking the size of losses.

-They are committed to making the ACA work for Tennesseans and hopes to re-expand their coverage in the future so are only cutting back in regions they feel have other options.

So it sounds like they are looking for the federal government to incorporate some fixes of some sort in the system which they hope will allow them to break even in all regions in the future.

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Old 10-11-2016, 08:16 AM   #3
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Lots of discussion on this in other threads, including this one BCBS withdrawal from much of TN individual market
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Old 10-11-2016, 08:27 AM   #4
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Originally Posted by MichaelB View Post
Lots of discussion on this in other threads, including this one BCBS withdrawal from much of TN individual market
Thanks for the link to the thread. I looked before making a new post but must have overlooked this one.

Interesting that BC members are not being notified of this change with a letter in the mail yet. I found out today after going on the BC website.
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Old 10-11-2016, 03:52 PM   #5
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The State of Tennessee was the guinea pig state that instituted Al Gore's Tenncare plan to replace Medicaid. It didn't work any better than the ACA, and is still a fiasco.

BCBS of Tennessee knows exactly where they're making money and they know where they're losing money, and they are simply unwilling to take such a bloodbath in red ink. They're just trying to protect their shareholders.

Vanderbilt Hospital has bought dozens and dozens of medical practices throughout the region. They and their 1700 physicians and P/A's are refusing to accept Medicare Advantage programs under any circumstances which has made a mass exodus of patients to other physicians. They're also in the process of forming management partnerships with all the hospitals in the state (except Knoxville), and will be controlling the healthcare in massive areas--parts of 6 states. Who knows what this will mean for the entire Mid South region?

With the ACA imploding, we'll just have to wait and see. I just hope BCBS doesn't drop my daughter's individual healthcare plan (not ACA) I pay for monthly.
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