Blue Cross and Blue Shield of Kansas City announced on Wednesday that it’s dropping out of the Affordable Care Act (ACA) exchanges in 32 counties in Kansas and Missouri next year, which will leave 25 Missouri counties without any choices in the exchanges market.
Meanwhile, BlueCross BlueShield of North Carolina said it’s staying in ACA exchanges in all 100 North Carolina counties, but also announced an average 22.9% rate increase. The payer said, however, that the increase would be only about 5% if the administration pays cost-sharing reduction (CSR) payments.
HHS also jumped into the ACA exchanges debate by releasing a report on Tuesday that said that individual health insurance premiums have grown an average of 105% since the ACA exchanges went into effect. Health policy experts criticized the report for including cost data from less comprehensive plans from before ACA’s protections took effect.
This has not been a great week for ACA exchanges. One payer is leaving 25 counties without any options, and another is looking to raise raises by 22.9% (if CSRs aren't paid) — and threatening to still possibly pull out of the exchanges in the fall.
The next month will also bring many payer announcements as insurance companies decide whether to stay in the ACA exchanges. Already this year, Aetna and Wellmark Blue Cross Blue Shield announced they are leaving the exchanges, while others like CareFirst BlueCross BlueShield announced rate increases, and others like Kaiser Permanente said they plan on staying in the exchanges.
In announcing Blue Cross and Blue Shield of Kansas City’s departure from the ACA exchanges, Danette Wilson, president and CEO of Blue KC, said dropping the exchanges market will affect about 67,000 of Blue KC’s more than 1 million members.
Wilson said the payer has lost more than $100 million through 2016 on the exchanges.
“This is unsustainable for our company. We have a responsibility to our members and the greater community to remain stable and secure, and the uncertain direction of this market is a barrier to our continued participation,” said Wilson.
Though staying in the ACA exchanges, BlueCross BlueShield of North Carolina also voiced concern about the ACA exchanges market. In a blog post, the company acknowledged “the 2018 increase is still too steep,” but “higher premiums are necessary because key federal funding for health coverage appears to be going away. Other reasons for the rate increase include a tax on health insurers under the ACA that’s scheduled to go into effect in 2018, as well as the higher costs of covering medical claims.”
The “key federal funding for health coverage” refers to CSR subsidies paid to insurance companies in the ACA exchanges. CSRs help payers cover lower incomes Americans. President Donald Trump has threatened to stop providing those payments, which insurance companies say will de-stabilize the market.
Blue Cross NC took aim at the White House and Congress by saying that the rate increase would only be between 5% and 6% if “the right actions" came from Washington "to stabilize the market.”
Though Blue Cross NC filed rates, the company also warned that “simply filing rates does not guarantee” that the payer will stay in the ACA exchanges market next year.
“We’ll continue to evaluate the market and make and announce a final decision this fall,” according to the company.