Multi-state plan paradox

Because the BCBSA is offering at least two plans in each of the states, the requirements of the law are met even though the OPM has a contract with only one issuer. The OPM did not publicly state how many applicants applied to the MSPP. The selection of the BCBSA, although not surprising, may not do much to increase plan choice or competition in heavily concentrated markets. In all but a handful of states, the BCBSA-affiliated plans are already the most dominant plans in the individual market.

via Health Policy Briefs.

A paradox of the Patient Protection and Affordable Care Act is explained in this Health Policy Brief by the journal Health Affairs. Multi-state plans were intended to increase competition in individual health insurance, particularly in state markets with only a small number of plan issuers.  However, the market dominance of Blue Cross and Blue Shield plan issuers in most states — plan issuers affiliated with the Blue Cross Blue Shield Association (BCBSA) — allows an affiliated plan issuer to designate two plan offerings as multi-state plans without altering the market share of the blue plan issuers.


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 or call 530-295-1473. 

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Frederick Pilot

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