Virginia: HEALTHCARE HOKEY-POKEY: Anthem back in again, all counties now covered!
Fri, 09/15/2017 - 2:37pm
Anthem said Friday afternoon it planned to scale back statewide individual coverage in Virginia on the public exchange under the Affordable Care Act amid inaction by the Donald Trump White House on cost-sharing reduction subsidies.
Anthem, which operates under the Blue Cross and Blue Shield plan in 14 states, has already scaled back its Obamacare offerings in Indiana, Ohio and Wisconsin amid an unstable individual market for plans operating under the ACA.
“Today, planning and pricing for ACA-compliant health plans has become increasingly difficult due to a shrinking and deteriorating Individual market, as well as continual changes and uncertainty in federal operations, rules and guidance, including cost sharing reduction subsidies and the restoration of taxes on fully insured coverage,” Anthem said in a statement Friday afternoon. “As a result, the continued uncertainty makes it difficult for us to offer Individual health plans statewide in Virginia.”
Effective in January of 2018, Anthem said it will "not participate on the individual exchange in Virginia and will reduce its plan offering and will only offer off-exchange plans in Washington and Scott Counties and the city of Bristol, VA."
Unfortunately, yesterday Optima Health announced that while they will be offering policies both on & off the ACA exchange next year, they're pulling out of a whole bunch of counties:
NORFOLK, Va.—Optima Health announced today it will continue to participate in the Individual market, offering plans both on and off the Affordable Care Act (ACA) Exchange, in Virginia in 2018.
“From day one, our desire has been to find a way to stay in the ACA Exchange,” said Michael M. Dudley, President and CEO, Optima Health.
With three national insurers—Anthem, Aetna and UnitedHealthcare—leaving the market, over 350,000 Virginians will be losing their healthcare coverage on January 1, 2018. The exiting of carriers along with the uncertainty in Washington, presented unprecedented circumstances.
“The decisions we made were challenging ones given the recent changes and ambiguities in the marketplace,” said Dudley. “Our most recent filing with the state reflects these dynamic changes, as would be expected in these circumstances.”
Optima Health is limiting its Individual plans offered on and off the 2018 ACA Exchange to locations where there are Sentara Healthcare hospitals and physicians. This will allow Optima Health to better manage chronic conditions to keep members healthy.
This move apparently means that the "bare county" problem--which was recently thought to be resolved with companies like Centene moving in to cover the last counties without any carriers participating--is back again: 63 of Virginia's 133 counties (technically 95 plus 38 "independent cities") are now facing no exchange carriers whatsoever. This will apparently leave around 70,000 current exchange enrollees without any carriers to switch to unless another carrier jumps in at the last minute.
September 14, 2017:
#ACASignups U.S. Senator @timkaine is basically threatening carriers that the solution to “bare counties” will be “Medicare option”.
— ☪️ Charles Gaba ✡️ (@charles_gaba) September 14, 2017
AWESOME! Sen. @TimKaine: “The insurance companies are holding a knife up to their own throat” by allowing bare counties.
— ☪️ Charles Gaba ✡️ (@charles_gaba) September 14, 2017
It’s one thing for a carrier to say “we need to raise rates X% to participate”; it’s something else to say they won’t participate AT ALL.
— ☪️ Charles Gaba ✡️ (@charles_gaba) September 14, 2017
Anthem Changes Course, Will Offer Obamacare Plans In 63 Virginia Counties And Cities
Anthem said it has revised its plan to offer individual health insurance in Virginia after “learning that 63 counties and cities” would be bare and have no access to coverage in 2018 under the Affordable Care Act.
It’s welcome news to Virginia residents but also a good move for Anthem, the nation's second-larges health insurer, which appears to be maintaining individual coverage in areas of the country where it will have a monopoly. Anthem has been scaling back in some of the 14 states where it operates under the Blue Cross and Blue Shield brand, but remaining in areas that are in jeopardy of not having an Obamacare choice for 2018.
There you have it. Every county in Virginia is now covered by at least one carrier for 2018 again. Yes, they jacked up their rates to cover the Cost Sharing Reduction reimbursements being sabotaged by Trump, as well as the threat by HHS Sec. Tom Price not to enforce the individual mandate...to the tune of a whopping 56% on average, according to Louise Norris, who also notes that, since they'll only be staying in half the state, the new filing only applies to around 61,000 current enrollees. That means the other 104,000 mentioned in Anthem's earlier filing will still have to shop around for a new plan from Optima. Anyone receiving subsidies via HC.gov policies shouldn’t be impacted since their tax credits will increase accordingly, but the unsubsidized nrollees are kind of screwed.
Still a hell of a lot better than no carriers, however.
Here's what the statewide average rate hikes now look like...around 34.3% if CSRs are paid, 48.6% if they aren't:
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