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Blue Cross Blue Shield Of Minnesota retreating from individual market for PY 2017

June 25th, 2016 Comments off

More than 100,000 Minnesotans will need to look for new insurance for 2017. Blue Cross Blue Shield is pulling back from the state’s market for individual policies, citing heavy losses.

Source: Blue Cross Blue Shield Of Minnesota Says Losses Were Too High : Shots – Health News : NPR

The individual market remains in a state of flux in some states in response to the Affordable Care Act reforms intended to restore it to functioning by setting up state exchanges offering premium and out of pocket subsidies, eliminating medical underwriting and requiring everyone to have some form of coverage year round.

Quoted in this item, Cynthia Cox of the Kaiser Family Foundation, provides this analysis:

“Right now what it seems like is that insurance companies are really trying to reset their strategy,” Cox said. “So they may be pulling out selectively in certain markets to re-evaluate their strategy and participation in the exchanges.”

She said the individual markets just aren’t turning out as expected. “The hope was that these markets would encourage exchange competition and [get] more insurers to come in. … I don’t know if we’re at a point where it’s completely worrisome, but I think it does raise some red flags in pointing out that insurance companies need to be able to make a profit or at least cover their costs.”

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Alaska poised to establish own reinsurance program for individual health insurance market, authorize 1332 waiver

June 10th, 2016 Comments off

Alaska’s relatively thin population makes it difficult to sustain a viable individual health insurance market. Too few “belly buttons” as plan members are termed within the industry doesn’t allow for adequate spread of risk so that premiums paid by members who use relatively little medical services offset those who use more. That also makes the state less attractive to health plan issuers since they could potentially suffer adverse selection.

The Patient Protection and Affordable Care Act’s individual market reforms included reinsurance to reduce that risk by compensating health plan issuers once medical utilization costs for a given member exceed a certain dollar amount over a plan year. That premium stabilization component that applies to plans sold in state health benefit exchanges goes away for plans effective in 2017.

Consequently, Alaska lawmakers approved legislation backed by Gov. Bill Walker to create its own reinsurance program for the individual market. HB 374 would also authorize the state to seek a state innovation waiver from the federal government under Section 1332 of the Affordable Care Act to establish its own state plan governing the individual market.

The legislation comes with a high level of urgency. State Insurance Division director Lori Wing-Haier told lawmakers that Alaska’s individual insurance market could collapse if it’s not enacted, according to this report. That’s not an overstatement given only one health plan issuer, Premera Alaska, remains in the individual market.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

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