Wellmark Iowa withdrawing from ACA market

[MichaelB]

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.

DES MOINES, IA — Wellmark Blue Cross and Blue Shield today announced their decision not to sell or renew individual and family Affordable Care Act (ACA) plans in Iowa with a Jan. 1, 2018, effective date.

Over the past three years, Wellmark members with individual health plans in Iowa, governed by the ACA, have endured double-digit premium increases. In addition, Wellmark has lost approximately $90 million in the individual ACA market during the same timeframe.

“Finding solutions to stabilize this market is in the best interest of all Iowans, including providers of health care and insurance carriers,” said Wellmark Chairman and CEO John Forsyth. “No one really benefits from rising costs. While there are many potential solutions, the timing and relative impact of those solutions is currently unclear. This makes it difficult to establish plans for 2018.”

This affects 21400 plans, but they will continue to provide plans to another 1.64M Iowa residents.

 

[frank]

its a shame wellmark is one of the most reputable and dependable providers.

 

[MBSC]

Aetna is also leaving the Iowa individual market in 2018.

Aetna Inc will exit Iowa's Obamacare-compliant individual insurance market in 2018. Aetna, citing financial risk and the uncertain outlook, said on Thursday it is still evaluating other remaining individual insurance markets, which include Delaware, Nebraska and Virginia.

Aetna is the biggest seller of Obamacare-compliant plans in the state and according to Iowa state insurance data, had more than 30,000 people in such plans in 2016.

Earlier this week Iowa's insurance regulator said that Wellmark Blue Cross Blue Shield would not sell Obamacare individual plans next year, affecting 22,000 people.

According to data provided by Iowa, Aetna accounted for most of the plans sold on the federally run HealthCare.gov website in 2016. Wellmark accounted for most of the plans sold in the state that comply with Obamacare but are not sold on HealthCare.gov.

Medica Insurance Company also sells Obamacare-compliant plans throughout the state but is the smallest player.

Reference: Aetna exits Iowa individual insurance market for 2018 | Reuters

 

[brucethebroker]

All we really needed was accessibility and affordability. Far too much was shoved down the throats of the insurance industry by the mandates. Now the chickens are coming to roost...

 

[MichaelB]

The individual coverage policies they sell are no different than the large group policies. They all have the same coverage components and are subject to the same requirements, mandates and regulations Wellmark and Aetna are choosing not to sell 44k individual policies (for now) but clearly are staying around for the millions of group policies.

 

[tomz]

Part of the problem is that Iowa allowed insurance companies to grandfather non compliant plans. Wellmark had 55,000 individuals in non-compliant plans at the end of 2016.

"...while grandfathered plans likely make up only about 5-10% of the individual market nationally, they may still comprise up to 45% of the indy market in Iowa even today." http://acasignups.net/16/08/30/iowa-approved-2017-avg-rate-hikes-301-some-rare-transitional-plan-data

 

[frank]

I have a grandfathered plan with wellmark in Iowa. it costs 861 per month for hsa with a 1600 dollar deductible for 1 person. If I went on the exchange,[ which I could have] it would have cost 1100 a month with a 6500 dollar deductible. how does that make sense?

 

[MichaelB]

Part of the problem is that Iowa allowed insurance companies to grandfather non compliant plans. Wellmark had 55,000 individuals in non-compliant plans at the end of 2016.

"...while grandfathered plans likely make up only about 5-10% of the individual market nationally, they may still comprise up to 45% of the indy market in Iowa even today." Iowa: *Approved* 2017 avg. rate hikes: 30.1% (+ some rare *transitional* plan data) | ACASignups.net

Interesting link, thanks.

 

[MBSC]

Aetna, United Health, and Innovation Health will not be in the Virginia individual market next year.

27 counties could have only one choice for 2018, said Katherine Hempstead, a senior adviser at the Robert Wood Johnson Foundation. Aetna pulls out of Virginia's individual market, citing big Obamacare losses - May. 3, 2017

Also, California will allow insurers to file two sets of rate requests for 2018.

More info: California will allow health insurers to file two sets of rates: One for 'Trumpcare,' other for Obamacare

 

[MBSC]

It appears Maryland residents may have several insurers to choose from in 2018, although insurers have until the end of October to change their mind about participating.

Health insurance companies have submitted average rate increase requests for the individual plan markets for 2018 to the Maryland Insurance Administration that range from 18 percent to nearly 59 percent. The insurance administration will issue decisions about 2018 rates in late summer.

“It is important to remember that these rates are what companies have requested, and not necessarily what will be approved,” said Insurance Commissioner Al Redmer Jr. “There will be a thorough review of all the filings. As in years past, we may require changes.”

CareFirst of Maryland (PPO) +58.80% average
CareFirst Blue Choice (HMO) +50.40%
CIGNA (PPO) +37.26%
Evergreen Health (HMO) +27.80%
Kaiser Mid-Atlantic (HMO) +18.08%

Reference: Obamacare rate increase requests up 18-59 percent in Md. | WTOP

 

[GTFan]

Holy crap, and that's on top of massive increases in MD last year (24% avg. according to KFF).

Jeez, at least there might still be insurers to pick from and if you get subsidies the premium doesn't matter that much but I feel bad for the folks that fall off the ACA cliff in MD. Got to be getting close to unobtainium levels in older age groups with these increases, if they aren't already there.

 

[Fedup]

Aetna, United Health, and Innovation Health will not be in the Virginia individual market next year.

Also, California will allow insurers to file two sets of rate requests for 2018.

More info: California will allow health insurers to file two sets of rates: One for 'Trumpcare,' other for Obamacare

From the article, only 700,000 get some subsidies or cost sharing assistance. Very tiny population.

 

[Blue Collar Guy]

wow, another one bites the dust

 

[samclem]

Also, California will allow insurers to file two sets of rate requests for 2018.

More info: California will allow health insurers to file two sets of rates: One for 'Trumpcare,' other for Obamacare

And they have until Monday (tomorrow) to determine what rates they'd like to charge under the AHCA--a piece of legislation that the Senate hasn't even touched yet, and for which no implementing regulations have been drafted? How could they possibly make such an estimate?

The intent of the Calif insurance commissioner is quite clear.

 

[MBSC]

Kaiser Permanente will participate in the 2018 individual market.

“Kaiser Permanente will continue to offer coverage -- including access to our complete network of world-class providers and services – through health exchanges in every region where we operate,” the organization confirmed.

Kaiser currently operates on individual healthcare exchanges in nine states: California, Colorado, the District of Columbia, Georgia, Hawaii, Maryland, Oregon, Virginia and Washington State.

Reference: https://healthpayerintelligence.com...te-will-stay-in-aca-health-insurance-exchange

 

[Fedup]

Kaiser is excellent. My kid is Kaiser.

 

[Tom52]

From a recent Des Moines Register article...

“Without swift action by the state or Congress to provide stability to Iowa’s individual insurance market, Medica will not be able to serve the citizens of Iowa in the manner and breadth that we do today. We are examining the potential of limited offerings, but our ability to stay in the Iowa insurance market in any capacity is in question at this point,” the company’s statement said.



Medica’s announcement comes on the heels of word last month that Aetna and Wellmark Blue Cross & Blue Shield would pull out of Iowa’s individual health insurance market for 2018. Those are the only three choices for individual health insurance in most areas of the state this year."


In my rural Iowa county for 2017 the only ACA provider available was Medica. There were a total of 5 types of policies. Now it sounds like they will likely be out of Iowa for 2018, as well as Aetna and Wellmark.

 

[GTFan]

Along those same lines:

Blue Cross Blue Shield of Kansas City out of Obamacare | The Kansas City Star

25 counties in western MO without an ACA insurer next year, and the rest of KC will now only be covered by Medica which has been capping enrollment.
This is how the exchanges are falling apart.

 

[GTFan]

Kaiser is excellent. My kid is Kaiser.

Wilhelm?

 

[Mulligan]

Along those same lines:

Blue Cross Blue Shield of Kansas City out of Obamacare | The Kansas City Star

25 counties in western MO without an ACA insurer next year, and the rest of KC will now only be covered by Medica which has been capping enrollment.
This is how the exchanges are falling apart.

If you are not reliant on subsidies or interested in crap policies, I strongly suspect there will be off exchange plans in western MO. We have several off exchange plans on other side of state.

 

[GTFan]

There are thousands of people getting policies with subsidies in that area that now have an uncertain future, regardless of whether folks here have alternatives.

 

[Mulligan]

There are thousands of people getting policies with subsidies in that area that now have an uncertain future, regardless of whether folks here have alternatives.

True, but my only purpose was helping the individual looking at options who are on this forum.

 

[Fedup]

Wilhelm?

 

[ivinsfan]

Posted by the only soul left in the US that can still crack jokes about healthcare..

 

[GTFan]

Kaiser is excellent. My kid is Kaiser.

Wilhelm?

*slaps head*

https://en.wikipedia.org/wiki/Wilhelm_II,_German_Emperor

History, forgotten by all those that will relive it (and on the 100th anniversary of our entry into the Great War, no less). And endure bad jokes about it.