Wellmark Iowa withdrawing from ACA market

[gerntz]

Part of the problem is that Iowa allowed insurance companies to grandfather non compliant plans.

Don't see that this is a "problem" given the promise that you could keep your insurance if you like it.

 

[Bamaman]

I pay $298 for a regular BCBS healthcare policy including dental for my 29 year old daughter. I consider myself lucky not to have to depend on the ACA for coverage. They go into the hole on her every month.

 

[MBSC]

Information on North Carolina's 2018 individual market.

Blue Cross intends to sell individual health insurance plans on and off the federal exchange in all 100 North Carolina counties. But the company said that the uncertain future of the ACA could determine whether Blue Cross will offer plans in North Carolina next year.

Blue Cross and Blue Shield, the state’s largest health insurer, is proposing a 22.9 percent rate increase on Affordable Care Act plans in 2018. Blue Cross said its rate increase proposal would be 8.8 percent if Congress continued fully funding the ACA in 2018.

Because 94 percent of Blue Cross’s customers in the state qualify for a federal subsidy to offset the cost of their monthly premiums, most customers will not feel the full brunt of the rate increase.

Cigna, which offers ACA plans in five counties in the Triangle, requested a 31.9 percent average rate increase.

Reference: BCBS asks to raise ACA rates 23% in 2018 | News & Observer

 

[Exit 2024]

I my view biggest flow of ACA was to not dissolve employer based plans, those include younger and healthier population leaving exchanges in disadvantage. If all population of each state would be buying through exchange - insurers would be piling up there as there would be no group business for them anymore. Employers subsidy could continue directly to employees and employees would have more choices.

 

[gerntz]

I my view biggest flow of ACA was to not dissolve employer based plans, those include younger and healthier population leaving exchanges in disadvantage. If all population of each state would be buying through exchange - insurers would be piling up there as there would be no group business for them anymore. Employers subsidy could continue directly to employees and employees would have more choices.

Well, many young are paying "tax" rather than buying policies. So don't see why they would if not getting through employer. Net, I think we'd have more uninsured under your proposal.

Why insurance premiums aren't treated the same for all - all taxable, all not - escapes me.

 

[Mulligan]

Well, many young are paying "tax" rather than buying policies. So don't see why they would if not getting through employer. Net, I think we'd have more uninsured under your proposal.



Why insurance premiums aren't treated the same for all - all taxable, all not - escapes me.

Hmm....If I could get a tax break on my insurance premium, and they double the HSA yearly contribution limit as has been proposed, suddenly I am not complaining about the high cost of insurance anymore.

 

[MBSC]

BCBS Nebraska is out of the 2018 individual market. They will allow policyholders to keep grandfathered plans.

Nearly 100,000 Nebraskans apparently will have only one choice for individual health insurance next year. And even that choice isn’t certain: Medica Health hasn’t decided whether to offer plans next year.

Reference: 100,000 Nebraskans could be left with no options if last insurer pulls out of ACA market | Live Well Nebraska | omaha.com

 

[MBSC]

Anthem Blue Cross Blue Shield will exit the Ohio on-exchange marketplace in 2018. They will sell off-exchange plans only in Pike County and allow members to keep grandfathered plans.

Anthem said it would continue to sell Obamacare compliant plans outside of the exchange in Pike County, Ohio as well as other individual plans that were grandfathered when the law went into effect.

In 2018, the move would leave about 10,500 people in at least 18 counties with no insurer.

Reference: https://www.nytimes.com/reuters/2017/06/06/business/06reuters-anthem-ohio.html

 

[MBSC]

Wellmark Iowa, BCBS, has announced it will no longer sell individual ACA plans, effective Jan 1 of next year. The reason is profitability and uncertainty.

An update on the Iowa individual market.

The Iowa Insurance Division is proposing a plan to stabilize Iowa's struggling individual insurance market. The division said the stopgap measure was designed in consultation with Wellmark and Medica.

The insurance division's proposal would offer a single, standardized insurance plan to be sold across the state. Premiums still would be subsidized based on age and income, and a reinsurance program would be offered to help with more expensive patients. Wellmark has agreed to offer the standardized plan in all 99 counties, if the plan's principles are approved in a timely manner, according to the insurance division.

For 2018, the plan would cover pre-existing conditions, and there would be no limits on annual or lifetime costs.

The plan would require federal approval, and Iowa Insurance Commissioner Doug Ommen said he is optimistic that the Center for Medicare and Medicaid Services would approve.

Source: Iowa floats plan for insurance markets | Iowa & The Midwest | globegazette.com

 

[GTFan]

From that article:
The plan says that it would take $352 million that it anticipated would have been needed in 2018 for premium reduction tax credits and cost-sharing payments for consumers and instead devote that money to premium reduction credits and a reinsurance pool. That will allow Iowa to provide a program that is "affordable and comprehensive" and yet be budget neutral for the federal government, the division said.

Wonder if the replacement of CSR subsidies will result in plans with unaffordable deductible/max OOP policies. It's great that premiums will still be subsidized for low-income folks but if there are no CSRs they could be looking at $2-4k in OOP expenses.

 

[MichaelB]

Here's a pretty good analysis and explanation from Health Affairs Blog (T. Jost)
Iowa Submits 1332 Waiver Request, Claiming It Is Necessary To Avoid An Individual Insurance Market Collapse

 

[MBSC]

BCBS Arizona and Health Net will remain in the 2018 AZ individual market.

Officials with Blue Cross Blue Shield Arizona and Centene Corp's Ambetter by Health Net say they've filed with the state Department of Insurance to continue offering insurance.

Blue Cross sells in 13 mainly rural counties and will maintain a similar set of plans. Health Net will again sell plans in Pima and Maricopa County.

Source: https://www.usnews.com/news/best-st...izona-health-insurers-sticking-it-out-in-2018

And more good news...

Centene, one of the largest players in the Obamacare individual insurance market, said it plans to enter Kansas, Missouri and Nevada in 2018, as well as expand its operations in six existing markets: Florida, Georgia, Indiana, Ohio, Texas, and Washington.

Source: UPDATE 1-Centene to expand Obamacare insurance to 3 new states in 2018 | Reuters

 

[GTFan]

Here's a pretty good analysis and explanation from Health Affairs Blog (T. Jost)
Iowa Submits 1332 Waiver Request, Claiming It Is Necessary To Avoid An Individual Insurance Market Collapse

Thanks for that, great article summarizing the crisis that Iowa is facing. From what I read they're only going to offer one Silver plan with a 68 to 72% covered actuarial value, with no CSRs (this means the insured is responsible for the other 30% of claim payments, drug costs etc. per year). This is the standard ACA Silver today which is far less than the max CSR 94 plans available now and could indeed result in unaffordable costs for low-income folks even with PTC subsidies. The reinsurance money that replaces CSRs will be used for max care payouts over $100k a year to help the plan cover the sickest folks.

The last para really summarizes the problem:
To stabilize the marketplaces in Iowa and elsewhere, Congress and the administration could immediately take steps to ensure that the cost-sharing reduction payments are funded, the individual mandate enforced, and risk corridor obligations met. Congress could also require Medicaid managed care plans to participate in the marketplaces, as New York intends to do. But amending the ACA is up to Congress, not Iowa.

 

[MBSC]

Anthem Blue Cross Blue Shield will not offer exchange plans in Indiana in 2018. Their off-exchange presence will be limited to a single plan in Benton, Jasper, Newton, Warren, and White counties. They will allow members to keep grandfathered plans.

Source: Anthem, MDwise to exit Indiana’s Obamacare marketplace in 2018 | Fox 59

Anthem also will not offer exchange plans in Wisconsin next year. Their off-exchange presence will be limited to a single plan in Menominee County only.

Source: http://www.channel3000.com/news/pol...consin-health-insurance-marketplace/555141620

 

[explanade]

Maybe the only way insurers would be interested in the individual market would be if the group market isn't so profitable for them.

It may take removing the tax advantages for employer-provided health care in order for the individual markets, especially in more sparsely-populated regions, to have a chance.

 

[athena53]

I'm in MO, near KC and every year I've had to switch carriers. Retired in 2014, switched for 2015 when my carrier offered only a crappier, more expensive version, same for 2016 and 2017. Current one, Humana, just announced they're dropping out of the Exchange for 2018. Thank heaven I turn 65 early next year.

I agree with earlier posts on group vs. exchange coverage. Group policies cover at least a primary insured (the employee) healthy enough to come to work most days, probably covered by insurance most of their lives. Many of the newly- insured through ACA are used to ignoring symptoms till they have to go to the ER and aren't used to preventative testing and healthy eating/living. On average, a different population.

 

[samclem]

Maybe the only way insurers would be interested in the individual market would be if the group market isn't so profitable for them.

It may take removing the tax advantages for employer-provided health care in order for the individual markets, especially in more sparsely-populated regions, to have a chance.

Maybe just require that any company selling group policies in a state must also offer individual/exchange policies
Rates on the exchange must, say, be the same for a 45 YO as their average group rate for all policies sold, they could vary per age and tobacco use per the existing Marketplace rules.
In times past this might have been seen as unconstitutional, an infringement on freedom of association (what biz is it of the govt to get between two parties engaged in sale of a legal product?) and an intrusion of the federal govt into state issues. But, we seem to be beyond all those nitpicking concerns in our present national "dialogue."

 

[MRG]

I'm in MO, near KC and every year I've had to switch carriers. Retired in 2014, switched for 2015 when my carrier offered only a crappier, more expensive version, same for 2016 and 2017. Current one, Humana, just announced they're dropping out of the Exchange for 2018. Thank heaven I turn 65 early next year.

I agree with earlier posts on group vs. exchange coverage. Group policies cover at least a primary insured (the employee) healthy enough to come to work most days, probably covered by insurance most of their lives. Many of the newly- insured through ACA are used to ignoring symptoms till they have to go to the ER and aren't used to preventative testing and healthy eating/living. On average, a different population.

I just had dinner with a guy from KC that I'd worked around most of my career. He and I retired a year apart and shared many notes. Some about healthcare.

He said last year he couldn't figure out how to make his situation work under ACA and went to the group market. He and his wife are a group of two(potentially an adult child too) under her existing business tax id number.

She's a independent person with a small business, has a tax id but no LLC etc, I guess he's a consultant(or spouse?). He said it was simple, easy, and on the up and up.

 

[GTFan]

It may take removing the tax advantages for employer-provided health care in order for the individual markets, especially in more sparsely-populated regions, to have a chance.

Well yeah, lots of us have said that here over the years. Probably one of the biggest obstacles to getting the individual markets fixed.

 

[MichaelB]

Maybe just require that any company selling group policies in a state must also offer individual/exchange policies

+1

And / or, require an company selling publicly funded insurance (Medicare, Medicaid, CHIP) to offer individual policies.

 

[MBSC]

Anthem Blue Cross will leave parts of California in 2018.

Monthly premiums for California health insurance plans sold under the Affordable Care Act will rise by an average of 12.5% next year.

About 10% of people enrolled through Covered California will also have to look for a new plan, as Anthem Blue Cross plans to end its coverage in most of the state. State officials said Tuesday that Anthem will continue providing coverage only in Santa Clara County and parts of Northern California and the Central Valley.

The average rate increases vary by region. An average 7% increase in San Francisco County compares with 13% in Los Angeles and 10% in Orange County.

Source: Covered California premiums will rise 12.5%, and Anthem Blue Cross cuts coverage - LA Times

 

[explanade]

Yup, I got the email from Anthem Blue Cross a couple of hours ago. I'm covered under one of their exchange plan.

I'm also in one of the counties that they will remain in.

It's odd, premiums in Northern CA are higher than those in Southern CA, because there are more providers or bigger provider networks in Southern CA.

That's a lot of customers they're giving up down there.

 

[Scuba]

Thank goodness we have a pre-ACA plan with Anthem Blue Cross in So CA. We received a letter telling us their decision to pull out of ACA plans in our area does not affect us, at least for 2018. Interestingly, about 2 months ago we got a letter from Anthem advising us that the state of CA had determined their rates for our plan to be unreasonable, and that if we wished we could cancel and go to a Covered CA plan instead. So glad we didn't do that! None of our docs accept Covered CA plans anyway.

 

[GTFan]

BCBS said yesterday that they are pulling out of the Atlanta market for 2018, citing continued regulatory uncertainty. But in return the AJC said that Ambetter will be entering the metro counties left by BCBS, which will again leave us with two insurers (Kaiser is the other and they're staying).

BCBS is only staying in the rest of GA (as the sole provider) after lots of arm-twisting by the state, apparently.

I hope that Ambetter picks up our Wellstar network of local doctors and hospitals, otherwise we may end up with Kaiser next year.
However, user reviews of Ambetter are horrible. They're running the low-end Peach State health plan here now.

https://bestcompany.com/health-insurance/company/ambetter/

 

[Sojourner]

BCBS said yesterday that they are pulling out of the Atlanta market for 2018, citing continued regulatory uncertainty. But in return the AJC said that Ambetter will be entering the metro counties left by BCBS, which will again leave us with two insurers (Kaiser is the other and they're staying).

BCBS is only staying in the rest of GA (as the sole provider) after lots of arm-twisting by the state, apparently.

I hope that Ambetter picks up our Wellstar network of local doctors and hospitals, otherwise we may end up with Kaiser next year.
However, user reviews of Ambetter are horrible. They're running the low-end Peach State health plan here now.

https://bestcompany.com/health-insurance/company/ambetter/

Wow... what a disaster. I'm on BCBSGA right now, so I guess I'm one of the lucky ones who'll get to switch to Kaiser or Ambetter next year.

I'd have no problem with Kaiser except my PCP -- who I really like and have been going to for years -- isn't in their network. And I'm betting he won't be in Ambetter's network either, judging by the absolutely scathing user reviews of this company. Oh well, it is what it is. I guess healthcare costs were always one of the biggest red flags for the RE crowd, so it was unreasonable for me to assume I wouldn't be affected by this at some point.