2018 MIDTERM ELECTION

Time: D H M S

ARIZONA: Pinal County crisis resolved (for now): BCBS agrees to jump back in

(this seemse to be worthy of a rare mid-week mailing...)

AS AN ASIDE...I'd like some feedback from everyone: Would you have any interest in an official ACA Signups smartphone app? Obviously you can just load the website, but I figured some folks might appreciate a Push Notice for significant developments such as this. If so, would you be willing to pay a modest fee for it (say, $10 or so)?

I don't know if this is an exclusive on the WSJ's Anna Wilde Mathews' part or not, but she's the first one I know of to break it:

Arizona’s Pinal County Gains Health-Law Exchange Insurer

Blue Cross Blue Shield of Arizona will offer plans on the Affordable Care Act exchange in Arizona’s Pinal County next year, resolving a situation that drew a national spotlight because it represented a major challenge to the mechanics of the health law.

When Aetna Inc. announced last month that it would withdraw from the exchange in Arizona, among other states, it left Pinal at risk of becoming the first U.S. county without a single insurer selling exchange plans. Aetna had been expected to sell exchange plans in Pinal County, where approximately 10,000 people had signed up for ACA plans.

Reminder: That 10,000 figure is actually wrong; the actual number who enrolled as of the end of Open Enrollment this year was 9,700, of which only 8,500 are actually receiving APTC assistance; this number has likely dropped further to around 7,200 as of today, and will likely be around 6,400 by the time December rolls around regardless. This is still a good development, however.

...Blue Cross Blue Shield of Arizona Chief Executive Rich Boals said in a statement that his company will be the sole exchange insurer in 13 of Arizona’s 14 counties in 2017. However, he said, “regulators and policy makers must find a way to stabilize the market and put long-term fixes in place. Meanwhile, BCBSAZ is trying hard to balance the company’s financial losses from the ACA with the very real concerns of Arizonans.”

...Neighboring Maricopa County is also now expected to have just one insurer, Cigna Corp., after Tenet Healthcare Corp.’s Phoenix Health Plans recently announced that it will withdraw from the exchange in the county. Phoenix Health Plans said in a statement that it had decided to discontinue the exchange plans “based on the economic challenges and underlying risks of the products.” That would represent a sharp drop-off for Maricopa, which has had a large selection of exchange insurers.

OK, so if I'm understanding this correctly, 13 counties will only have BCBS AZ on the exchange, and the last one (Maricopa) will only have Cigna. I was under the impression that HealthNet was also planning on being available on the exchange in at least one county, but apparently not (and given how rapidly things have been changing in Arizona lately, I don't feel too bad about missing that one).

One thing the WSJ story doesn't mention is what BCBS's actual rate hikes will be. My most recent filing data has it at a whopping 51.2% average statewide, but it's possible that the recent developments might change that as well.

Update: Yep, this has been confirmed by a Casa Grande Dispatch article about the same development:

Jeff Stelnik, senior vice president of sales, strategy and marketing for Blue Cross Blue Shield of Arizona, told The Associated Press the company still has concerns about the financial viability of the exchanges but felt it was necessary to give Pinal County residents a marketplace insurance option. He said rates will increase by 51 percent in 2017 in the county, but noted most of that will be offset by new subsidies available to Arizona residents next year.

Of course, only about half of the indy market enrollees nationwide are receiving subsidies, but....(sigh) ok, ok...

Anyway, kudos to CMS/HHS for managing to pull this one out of the fire, but BCBS's CEO certainly isn't wrong when he says that stabilization is needed; you can't have hundreds of counties (and thousands of residents) wringing their hands every year wondering whether they'll find themselves in the same situation.

In the meantime, it sounds like Michael Cannon's recent "academic exercise" (his description as well as mine) has just become moot.