Blue Cross Blue Shield (Possibly) Offering Insurance on Exchanges in 2018
Recently, there was some speculation (read: outright panic) over whether or not 96 of our 159 counties would have insurance plans available on the Patient Protection and Affordable Care Act (PPACA) exchanges in 2018. Last week, Blue Cross Blue Shield submitted proposed rates for all areas of the state to the Office of Insurance and Fire Safety Commissioner, according to the Macon Telegraph:
The Georgia insurance department had asked insurers that want to offer exchange coverage to submit their proposed rates by May 16, while the federal deadline is June 21.
The proposed rates will be publicly available after June 21, the agency said.
Submitting rates is only the first step in the process, however, as Commissioner Ralph Hudgens has to sign off of them, and Blue Cross Blue Shield still can opt to withdraw at any time. This latter point is important, given the current state of PPACA and the plans to repeal it.
Blue Cross Blue Shield’s signaled commitment to the Georgia exchanges in 2018 comes at a time when the Trump Administration and House Republicans have filed a motion in federal court to hold a case for 90 days regarding the constitutionality of cost-sharing reductions in PPACA. The purpose of the cost-sharing payments is to reduce the out-of-pocket expenses of low income consumers, but Republicans in Congress have refused to fund the payments in the past, leading to the Obama Administration funding them without a specific allocation. House Republicans sued the Obama Administration in 2014 for illegally authorizing the payments, and a lower court agreed with them.
A decision on this question would considerably calm insurers like Blue Cross Blue Shield because for now there is no guarantee companies would be reimbursed for cost-sharing payments after May 31. The Trump Administration has committed, however, to funding the reimbursements through May. If the motion to delay is granted, insurers planning to participate in 2018 may fear the marketplace is too unstable and pull out. In the case of Georgia, such a move would leave much of the state without a participant to offer insurance plans to consumers required to purchase plans under current federal law.
The Trump Administration has argued that payments beyond May will not be necessary due to the president’s plan to repeal PPACA. However, the likelihood that any repeal legislation would be passed by the Senate, reconciled with the House-passed repeal bill, and signed into law by June 1 is fantastically optimistic. The Senate’s 13-member working group has not yet provided a concrete agenda for what that chamber’s bill will include. On Sunday, Senate Majority Leader Mitch McConnell suggested that a vote on repeal legislation may not happen until sometime in July.
Meanwhile, Blue Cross Blue Shield has released a “wish list” for PPACA repeal that includes familiar portions of the current law, such as continued protections for people with pre-existing conditions, no lifetime cap on benefits, and no higher premiums based on gender — while enforcing stricter penalties on individuals who don’t maintain insurance coverage. (Doesn’t this sound a lot like the current law?) Republicans have made repealing the requirement to purchase insurance a keystone of their repeal plans, and in the recently-passed House version, some of these other items were rolled back or removed.
Given that other large insurers, like Aetna and UnitedHealthcare, have already quit participating in PPACA exchanges, Blue Cross Blue Shield becomes all the more powerful when it comes to shaping the Republicans’ plan to replace PPACA. It will be fascinating to see how much of the company’s blueprint ends up in the Senate bill.
About Author
Holly Croft
Holly is an archivist at one of Georgia's institutions of higher learning. In a past life, she was a legislative assistant on Capitol Hill. She cares a lot about records management, open records laws, and privacy laws. Political persuasion? It's complicated. What's not complicated is that she's proudly equal parts Bulldog and Tar Heel.
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This idea that you can blame the current status of Obamacare on republicans is absurd.
105% – The national average increase of Obamacare premiums from 2013-2017
106% – The average increase in premiums in Georgia in the same period.
$209 – The average cost of a plan in Georgia in 2013
$431 – The average cost of a plan in Georgia in 2017
25% – The average increase in premiums just in the past year. (nationally)
1,021 – The number of counties in this country that have only one insurance provider.
5 – The number of states who have only one choice in insurance providers.
“It’s not that our liberal friends are liars. It’s that they know so much that just isn’t so.” RR
I would like for you to defend the numbers I listed above when you give your “thoughts” on what works and doesn’t work. All you do is change the subject when the current status of Obamacare is mentioned because you have no desire to defend it or you are incapable of doing so. Either way, we tried your way. It failed.
So your defense of the numbers are 1) Prices were already going up. So what if they continue. 2) Who cares if premiums are going up. The taxpayers will continue to pay for the increases. 3) Instead of offering a product that people will actually want we will force them to buy what they don’t want with an ever increasing penalty. 4) Who care if you live in a state that doesn’t have a provider on the exchange. We will still penalize you. 5) Obama tried hard. So give him a break.
All terrible and worthless responses. These are what we call excuses. Not solutions. It’s always someone else’s fault with you. You will never look at the facts and say Obamacare was so flawed from the beginning it was destined to fail. You will blame republicans and Paul Ryan. But you have never ever blamed the members of congress and the president who signed the turd of a bill into law.
I’m done arguing with you. Keep lying to yourself and blaming others. Some of us will try to clean up your mess while people like you try to vilify us all along the way.
Saying the same thing just in longer sentences does not help your argument. That’s typical of you lawyer types. If the facts don’t work talk them to death. I’ll repost my original comment because you said nothing new.
1) Prices were already going up. So what if they continue. 2) Who cares if premiums are going up. The taxpayers will continue to pay for the increases. 3) Instead of offering a product that people will actually want we will force them to buy what they don’t want with an ever increasing penalty. 4) Who care if you live in a state that doesn’t have a provider on the exchange. We will still penalize you. 5) Obama tried hard. So give him a break.
Good posts. I’ve discovered you can’t have a rational discussion on this topic with this poster. Thanks for trying.
If you have been following this website for any amount of time you know that Andrew and I have had many rational discussions on this topic. I’m tired of repeating myself and tired of being vilified for trying to fix other people’s mistakes. That is all.
There’s probably really only one or two things that are needed to fix Obamacare:
1. Raise the penalty for not having insurance.
2. Provide a short term relief plan (like was in there before Rubio killed it) for insurers until the market stabilizes.
Insurers will stay in, prices stabilize, everybody has insurance… what’s not to like?
I think it’s the conservative Pavlovian reaction to anything ‘Obama’ that has prevented Republicans from even considering tweaks to the program.
But we shall see. Either a new plan will pass or it won’t. What would be par for the course is they end up passing something that looks like Obamacare but tweaks things in the wrong direction making everything worse.
Withholding critical context is intellectually dishonest. Comparing the premiums for typical pre-ACA plans that didn’t cover maternity, mental health, pre-existing conditions, and other essential benefits to ACA plans that do isn’t intellectually honest. Calling out premium increases under the ACA without mentioning that they came in lower and increased less than forecast is intellectually dishonest. Calling out the number of rural counties that have one or no providers without mentioning the role that GOP sabotage of risk corridors and cost sharing played in driving insurers out of those high-cost markets is intellectually dishonest.
Eiger may be “good people” — I have no reason to think otherwise — but he’s intellectually dishonest on this subject. The fact that he’s informed only demonstrates that the dishonesty is willful.
Bottom line for me: The ACA insured 20 million people, could have insured more with full Medicaid expansion, did it at a lower cost than forecast and with lower cost inflation than forecast, and did it with private insurance markets rather than government-run health coverage. It’s saved lives and protected families from medical bankruptcy.
We can build on that, or we can scrap it. If we do the latter, it’s trivially true that insurance premiums can be lower as long as the insurance doesn’t cover sick people.
“You should know that once we have fully implemented, you’re going to be able to buy insurance through a pool so that you can get the same good rates as a group that if you’re an employee at a big company you can get right now — which means your premiums will go down.” – Barack Obama
So I’m dishonest for pointing out the fact that democrats promised that premiums would go down when they were trying to sell Obamacare? Was Obama dishonest when he said the quote above? If you want to debate this topic you need to have an understanding of what was promised in 2009 and 2010 by the democrats. You clearly have no idea and are late to the game.
Also, if you want to talk about being dishonest let’s talk about blaming the failure of Obamacare on states that could not afford to expand Medicaid. That is the definition of being dishonest.
“If we do the latter, it’s trivially true that insurance premiums can be lower as long as the insurance doesn’t cover sick people.” False once again. If you offer a product that young healthy people will actually buy you get more of them in the pool to cover sick people. Right now young healthy people are not buying plans that they don’t want because the are too expensive.
If you want to debate this with me you are going to need more facts than just calling me dishonest.
Lastly, here is the “context” you need on the numbers I listed above.
https://aspe.hhs.gov/pdf-report/individual-market-premium-changes-2013-2017
Maternity care will be handled like other extras and insurance itself. Enroll when you need it, drop it as soon as possible thereafter, making it a lesser version of failed high risk pools.
“You should know that once we have fully implemented, you’re going to be able to buy insurance through a pool so that you can get the same good rates as a group that if you’re an employee at a big company you can get right now — which means your premiums will go down.” – Barack Obama
Yes, given that he was speaking of future conditions, he always should have said “your premiums will be lower than they otherwise would be.” As the CBO score quantified, no one expected actual premium deflation — the projection was that the inflation rate would decrease (which it did, by more than projected). If your argument is that Democrats should have been more rigorous in their efforts to explain this, I can’t really disagree. Obama and Democrats should have been clear and consistent that premiums would go down relative to the pre-ACA baseline. They weren’t.
1. Obamacare hasn’t failed: it’s insured 20 million people at lower than expected costs.
2. The choice of some Republican governors not to expand Medicaid added disproportionately poor, sick people to the exchange markets, which made offering coverage in those markets more expensive for insurers, which reduced the number of insurers willing or able to offer coverage in those markets. This was exacerbated by GOP sabotage of risk corridors and cost sharing.
The plans are “too expensive” because insurers are required to offer them to sick people. This is called “cross-subsidy,” and it’s the same mechanism by which my employer-sponsored group insurance plan works. I’ve never spent the night in a hospital, but I pay the same amount as my colleague with cancer.
You can reduce premiums for healthy people by getting the sick people out of the pool. You can do this by allowing insurance companies to simply deny coverage to sick people, or to drop coverage when people become sick, as they did pre-ACA. You can do this by allowing insurance companies to charge much higher premiums to sick people, effectively denying coverage to all but the affluent sick.
You could also accomplish this with “high-risk pools,” which would be fine with me. But then you have to heavily subsidize the sick people, because premiums in plans exclusively offered to sick people are extraordinarily expensive. You could create high-risk pools with a defined benefit, so that sick people are guaranteed a certain standard of care (like Medicare) and the government provides whatever subsidies are required to make it affordable. In this case, taxpayers are directly subsidizing coverage for the sick rather than younger, healthier people doing so through cross-subsidies and higher premiums.
Either way, providing affordable health care to sick people is expensive and someone is going to pay. The high-risk pools in the AHCA are a fraud, because they don’t guarantee a defined benefit — they simply provide a (not sufficient) fixed funding pool from which states may finance some subsidies. If the subsidies aren’t enough to enable a sick person to afford coverage, tough toenails.
Honest conservatives will simply admit, “Yeah, I don’t want the government to guarantee sick people affordable access to health care.” Republicans have become much less likely to stake out the honest position because it’s become politically very unpopular.
I love how your tone changed from me being intellectually dishonest to Obama could have done a better job explaining how premiums wouldn’t actually go down. I guess you fail to see the hypocrisy in that.
I’m more than happy to talk about solutions with you. Andrew and I have been doing this for quite sometime, but I won’t back down and be vilified for working to fix the failures of Obamacare. I won’t be called dishonest without calling you a fool for saying so. Now that’s over. Let’s chat.
1) I dispute your 20 million figure. If you look at the actual enrollment numbers no more than 11 million people have enrolled in ACA plans in a single year. Here’s more reading on this. Doug is stupid, but I’m sure you won’t agree with him. http://www.twincities.com/2017/03/14/doug-badger-have-20-million-people-gained-coverage-under-the-aca/
2) You are still blaming republicans governors for knowing that they could not afford to expand Medicaid. Their options were to expand Medicaid and then when the federal dollars run out kick people out of Medicaid or raise taxes to cover the budget hole. Most states’ Medicaid budget is around one third of the entire budget and unlike the feds they have to balance the budget. Expansion was not possible for most states. That’s why they didn’t do it. Not because they were evil. So stop insinuating that.
Medicaid was designed for people who are truly needy. By dumping able bodied individuals into the Medicaid pool you are only harming the folks who need Medicaid the most. There are a number of innovative solutions that states are working on. Maine’s invisibles high risk pool is one of those ideas. The Medicaid dollars flow to the individuals who truly need help. I would encourage you read about it.
“In this case, taxpayers are directly subsidizing coverage for the sick rather than younger, healthier people doing so through cross-subsidies and higher premiums.” But younger people aren’t buying the insurance plans offered because they don’t want them or can’t afford them. Plain and simple. You have to get them into the market. The mandate hasn’t worked. You could increase it to something outrageous and truly harm people for not having insurance. I don’t like that idea. Or you can use tax credits, refundable tax credits and other carrots to get young healthy people into the system along with offering plans that they want.
You can continue to say that Obamacare is working, but that doesn’t make it so. It has failed at what it was sold as and it is collapsing on it’s own weight. Doing nothing is not an option.
The AHCA is far from perfect, but is a start in the right direction. You have to work with the political environment and rules you are given. Right now a reconciliation bill that the senate will work to make better is what we have.
Yeah, I shouldn’t have gotten sucked back in. I think your discussions of the topic are intellectually dishonest. You think I’m a fool.
We can leave it there.
Yeah, I shouldn’t have gotten sucked back in. I think your discussions of the topic are intellectually dishonest. You think I’m a fool.
We can leave it there.
Well, as Andrew said. Bye Felicia.
this conservative simply didn’t want his rates to triple, his deductible to double or to have to switch doctors and pay for coverage he doesn’t actually need like maternity or children’s dental…but, alas
honestly
I think young people don’t buy insurance because
1)they know if they get really sick, just go to the emergency room, get fixed, then show you have nop ability to pay, hospital gets stuck with the bill.
2) Insurers can price you out of coverage or deny services once you actually have a medical claim. There is no incentive to pay for a scam that will not payout when you need it. Why would young people throw money away on such a scam?
Are we going to stop treating people that make it into the emergency room without ability to pay? Will there be a ‘wallet biopsy’ before you can see a doctor or get emergency care? I’m surprised the GOP hasn’t thought of this and made it law.
Until Insurance has guarantees not to drop coverage when you are sick, or drop your plan to force you into higher rates, or have astronomical increases to force you out we aren’t going to increase the number of suckers buying into the current system.
Insurance companies need to offer incentive programs that keep long term subscribers by offering lower rates to stay with the company. This assumes we keep the current dysfunctional system of competing insurance plans. I would prefer a simpler selection. Much like Medicare, all the same coverage, just packaged by different carriers. Strangely, many people don’t compare the rate plans to get the best rate for the same medicare coverage.
“Insurance companies need to offer incentive programs that keep long term subscribers by offering lower rates to stay with the company.” I think this is a great idea. Too bad it’s illegal under the ACA.
Premium increases are no different than Pre ACA. Yet you try to blame it on ACA here and in other threads.
I’ve seen the increases in my own household, retiree, individual and employee based. 10-22% increases on policies that were kept. That is inline with pre-ACA annual increases. I don’t like what I’ve been through with ACA. I’ve made that clear in prior discussions. I accepted it based on certian expectations of a leveling out of premiums, equal premiums, protection of insurance and the idea that more insured would keep smaller hospitals and providers in business to serve the insured and not-so-insured without going bankrupt.
Just because it was happening pre ACA doesn’t mean it’s okay. Why is that so hard to understand? I’m not for going back to pre ACA.
Obama and the democrats said that premiums would go down under the ACA. Not me. I’m simply highlighting the fact that they were wrong. Very, very wrong.
‘premiums would go down’, I’ll add that to my list of soundbites to remember about ACA. I agree, the 20-30% annual increases were not acceptable for most consumers. Especially when Insurers can price you out of coverage or deny services once you actually have a medical claim.
But it was obvious premiums had to start higher under ACA with certain mandated coverage.
“no lifetime cap on benefits” that was one of those misleading phrases. Sound good, especially to insurers, as it them gave them an excuse to keep premiums high.
Truth: “No Lifetime cap” only applied to mandated coverage such as preventative care, immunizations and screenings. Some fine print.
As long as insurance can cap your max days in intensive care, hospitals, rehab, nursing home, physical therapy, etc. the selling of a “no lifetime cap” is extremely fraudulent.
I think I implied that the uncertainty could cause BCBS to pull out of the exchanges pretty heavily, but maybe the dots were harder to connect than I thought they were. Apologies! It’s still a very real fear amongst those in the state that have to comply with the law.
Single payer, Medicare for all, here we come. Keep it up insurers, keep it up.