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.

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Andrew C. Pope
Andrew C. Pope

Wanted to point out the absolute stupidity driving Republican unwillingness to support cost sharing subsidies. Not funding the subsidies will cause providers like BXBS to pull out of markets and will make plans from the providers that stay prohibitively expensive for lower income Americans. The negative impacts of this will fall most heavily on areas that voted, by and large, for Trump. Trump and noted policy wonk Paul Ryan seem to think that, if they induce these death spirals and crash Obamacare 1) voters will blame it on the Democrats and 2) Democrats will be forced to come to the… Read more »

The Eiger
The Eiger

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… Read more »

Andrew C. Pope
Andrew C. Pope

…and the Republican alternative is to eliminate cost sharing subsidies that lower out-of-pocket costs for consumers, followed by a healthcare plan that increases the number of uninsured by 24 million by 2026, would result in 2018 and 2019 premiums 15 to 20 percent higher than under Obamacare. Then, to top off that turd sundae, the GOP wants to allow insurers to charge more to patients with preexisting conditions (while drastically underfunding high risk pools) and wants to allow insurers to treat maternity coverage and prenatal care as “extras,” leading to higher premiums for women. Eiger, we could go back and… Read more »

The Eiger
The Eiger

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.

Andrew C. Pope
Andrew C. Pope

Premiums have gone up, yes. But they’ve gone up at a much slower rate than during the Bush Administration. From 2001 to 2005, employer based premiums (where the vast majority of Americans get their insurance) increased by 54%. Compare that to a 16% increase from 2011 to 2015. As the CBO has said, premiums for employer-based coverage will be 10% to 15% lower by 2025 than they would have been without Obamacare. The Robert Wood Johnson Fdn. found that national health care spending will be $2.6 trillion (11%) lower from 2014 to 2019 than initial CBO projections. Brookings estimated that… Read more »

The Eiger
The Eiger

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… Read more »

Andrew C. Pope
Andrew C. Pope

1) Prices were already going up and prices will always go up (that’s called inflation, homie). The real challenge is slowing that growth, which Obamacare has done. If Democrats had passed a law which effectively lowered the rate of inflation on beer prices at baseball games, you’d be pitching a fit because beers still cost $10. 2) You presented figures about a) premiums increases and b) the average cost of a plan. Having had multiple discussions with you I’m going to assume you are well aware of how Obamacare subsidies are structured and that you know the subsidies cover these… Read more »

The Eiger
The Eiger

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… Read more »

Andrew C. Pope
Andrew C. Pope

Bye Felicia.

GregB
GregB

Good posts. I’ve discovered you can’t have a rational discussion on this topic with this poster. Thanks for trying.

The Eiger
The Eiger

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.

Andrew C. Pope
Andrew C. Pope

Nah man, Eiger is good people. Informed. Wiling to actually provide supporting figures (although sometimes without context). With some folks, there’s no way you’ll ever catch them sallying forth to offer something of substance.

Benevolus
Benevolus

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… Read more »

GregB
GregB

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… Read more »

The Eiger
The Eiger

“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… Read more »

Andrew C. Pope
Andrew C. Pope

Young people aren’t buying insurance because they don’t think they need insurance, not because the insurance available to them is “too expensive.” I don’t think that’s going to change just because AHCA plans cost less and cover less. (Source: me being a young person who spends 90% of his time with other youths) We both agree on the need to get healthier people into the pool, that’s just math. However, I’m just not sure stripped down plans are the ticket, particularly with young women who will want coverage for prenatal care, maternity care, family planning, etc. things automatically covered under… Read more »

Dave Bearse
Dave Bearse

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.

NoParty4Me
NoParty4Me

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… Read more »

The Eiger
The Eiger

“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.

GregB
GregB

“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… Read more »

The Eiger
The Eiger

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… Read more »

GregB
GregB

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.

The Eiger
The Eiger

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.

drjay
drjay

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

NoParty4Me
NoParty4Me

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… Read more »

The Eiger
The Eiger

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.

NoParty4Me
NoParty4Me

‘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.

NoParty4Me
NoParty4Me

“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.

GeneHartke
GeneHartke

Single payer, Medicare for all, here we come. Keep it up insurers, keep it up.