May 24, 2017
Next year, South Carolinians who seek to enroll in an Affordable Care Act (ACA) exchange plan will have only one choice. After a series of exits by major health insurance providers including Aetna, Blue Cross Blue Shield of South Carolina stands as the lone issuer of policies in the Palmetto State.
Previously, South Carolina’s ACA exchange platform offered plans from five health insurers. In addition to Aetna, Coventry and Consumer’s Choice have left the ACA marketplace, reports the Post and Courier in Charleston. Fortunately, Blue Cross Blue Shield of South Carolina, which currently provides coverage for 200,000, intends to stay on the exchange through next year, although a spokesperson for the insurer told the Post and Courier the company will closely monitor the healthcare debate now swirling in Washington.
“Like everyone else, we continue to pay close attention to what’s happening in Congress,” Patti Embry-Tautenhan said, "which promises to be fluid for the foreseeable future.”
Dwindling Choices in Several States
South Carolina’s situation mirrors what’s happening in other states where health insurers have exited ACA exchanges due to mounting losses, leaving residents with fewer options. Bloomberg reports all counties in Alaska, Wyoming, Oklahoma, and Alabama offer exchange-sponsored plans from only one insurer.
Likewise, many Iowa residents will be down to a single provider in 2018, and 16 counties in Tennessee may be left with no choices next year following Humana’s exit from that state. According to research from healthcare consultant Avalere and the AP, one insurer in 40% of U.S. counties will administer plans on the ACA exchange next year.
Those percentages could change as insurers receive more clarity from Congress on the healthcare reform bill that could radically alter the current ACA model. Specifically, insurers and state insurance agencies await the final fate of subsidies for low-income people to buy policies on the exchanges. Last month, President Trump suggested halting payments from the federal government in an effort to persuade congressional Democrats to negotiate on healthcare.
“The cost-sharing reduction piece has got to be the No. 1 issue for us in South Carolina,” Ray Farmer, Director of the South Carolina Department of Insurance, told the Post and Courier. “In my opinion, the market will implode if [Congress doesn't] fund the cost-sharing reductions and address it going forward.”
A shake-up of insurers on the ACA exchanges is imminent, as insurers are required to submit their applications to state insurance agencies by late June. South Carolina’s deadline is set for June 26, and Farmer relayed that his office has asked insurers to file two proposals based on whether or not the subsidies are available.
Despite the dwindling number of insurers in several states, the majority of people who receive health insurance from the ACA exchange still have a variety of choices. Bloomberg’s analysis of state marketplace and HealthCare.gov data showed more than one in three applicants can pick from at least four insurers.
Premium Hikes on the Horizon?
Rate filings have begun to trickle in in some states, and early data points to increased premiums. The Houston Herald reportsexchange insurers in Virginia and Maryland have requested rate hikes ranging from under 10% to more than 50%.
With healthcare still in flux, providing definitive answers to your clients is difficult. Continue to follow the ongoing deliberations in Washington. For clients who have purchased or plan to purchase an ACA exchange plan, know which insurers remain in play in your state and if those companies intend to raise premiums. Your clients depend on you to give them the vital information they need to make wise healthcare coverage decisions.
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