Dive Brief:
- Blue Cross Blue Shield of North Carolina gained $400 million in profits from its ACA plans on Healthcare.gov from 2014 through 2015, according to a USA Today report.
- However, the company's rate increase is at approximately 32% for the 2017 plan year, the report added.
- Spokeswoman Darcie Dearth told USA Today while documents show the amount BCBSNC made on these plans from Q1 to Q3 this year is almost the same, operating expenses are not included in the data.
Dive Insight:
BCBSNC would not be the first health insurance giant to have remained profitable after they began providing ACA coverage. The top five largest insurers in the country - Aetna, Anthem, Cigna, Humana, and UnitedHealth – collectively profited more than $65.5 billion since the ACA was implemented in 2011 through 2015, Public Citizen reported earlier this year. The average premium rate increase was about 25% across the country for the current enrollment period.
The insurers have also dramatically reduced their number of ACA plans for 2017, citing financial losses on the exchanges from covering a sicker patient population. Further, BCBSNC is among the insurers that has filed a lawsuit against the federal government over failing to provide the totality of the risk corridor payments it is owed since 2014.
“The federal government’s failure to honor its legal obligations contributed significantly to our ACA losses in 2014 and 2015 and makes it more challenging for our company to continue selling ACA products to our customers,” BCBSNC President and CEO Brad Wilson said in a June statement.
CMS acting Administrator Andy Slavitt has previously said that when it comes to understanding how to adjust prices on ACA plans, the country's health insurance market is in a "five year learning and experimentation stage." He encouraged insurers to learn cost-reduction processes for consumers from the hospitals that have benefited from the ACA, and highlighted some of the actions the agency has taken to "strengthen the risk pool, limit upward pressure on rates, and provide a strong foundation for the marketplace for the long term."