Issuer churn continues among non-group plans despite ACA’s statewide risk pooling

Cyndee Weston has navigated the shifting ground better than many. For years she has had the same insurer — BlueCross BlueShield of Oklahoma — which has dominated that state’s market for individual plans and is the only marketplace player for 2018. But even though the carrier is the same and the health law requires insurers to take all comers, canceled plans each year force her to learn a new coverage design, file new paperwork with doctors and worry her primary physician will be dropped from the network.

Source: Churning, Confusion And Disruption — The Dark Side Of Marketplace Coverage | California Healthline

Before the Patient Protection and Affordable Care Act’s non-group market reforms took effect in 2014, plan issuers frequently shut down plans, placing them in runoff mode once the pool quality declined too much and they fell into the adverse selection death spiral. It appears however the pattern nevertheless continues even with the Affordable Care Act’s requirement that all non-group risk be pooled into single statewide risk pools, making it tough on plan members seeking stability.

 


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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