In a letter to Tennessee Insurance Commissioner Julie Mix McPeak on Tuesday, Blue Cross Blue Shield of Tennessee President and CEO J.D. Hickey said the payer plans to cover the Knoxville region in the 2018 ACA exchanges, but it still has some concerns.
McPeak told The Tennessean, “They have put some caveats on what might happen in terms of claims experience and the federal action, but at this point, they are willing to cover Knoxville for 2018… It’s our first glimmer of hope for that area.”
Blue Cross Blue Shield of Tennessee reported that its 2017 performance in the ACA exchanges has improved because of better claims experience and a “sustainable rate structure based on the medical needs of the members.” Hickey wrote that the payer had experienced three consecutive years of “volatility and losses totaling more than $400 million” before this year. The insurer pulled out of Knoxville last year.
Hickey wrote that the move isn’t a “political decision” and Blue Cross Blue Shield of Tennessee is still concerned about the exchanges' stability. Hickey wrote that the insurer’s concerns about the market include “the elimination of Cost Sharing Reduction subsidies (CSRs), the removal of the individual mandate and the collection of the health insurer tax.”
However, Hickey said offering plans in those counties is “an extension of our mission to serve our fellow Tennesseans, especially those who do not have other options for coverage.”
The announcement comes after Humana announced that it is pulling out of the exchanges in 2018, including the eastern Tennessee counties. Humana's move meant that 16 counties in eastern Tennessee wouldn't have had any payers in the ACA exchanges next year.
Over the next few weeks, payers will decide on 2018 rates for ACA exchange plans. Some insurers have already said they are pulling out of the exchanges next year. Other payers say they are concerned with the system because of possible changes by Congress. They are also worried about whether Republicans will continue CSR subsidies to insurers. The subsidies help pay insurers for the coverage of lower income Americans.
White House officials have said that more payers dropping out of the ACA exchanges could help Republicans repeal the ACA and replace it with another law. Republican senators are now working on their own healthcare reform bill after the House narrowly approved the American Health Care Act in a 217-213 vote last week.