Blue Cross and Blue Shield of Kansas City announced it will not offer individual Affordable Care Act exchange plans in its 32-county service area in Kansas and Missouri in 2018. That leaves about 19,000 people with no exchange plan choices unless another insurer steps in.
Of Blue KC’s one million members, about 67,000 will have to find another option for health insurance next year.
“Since 2014, we’ve expended significant resources to offer individual ACA plans to increase access to quality healthcare coverage for the Kansas City community,” Danette Wilson, president and CEO of Blue KC, said in a statement.
“Like many other health insurers across the country, we have been faced with challenges in this market. Through 2016, we have lost more than $100 million. This is unsustainable for our company. We have a responsibility to our members and the greater community to remain stable and secure, and the uncertain direction of this market is a barrier to our continued participation.”
Insurers are setting rates for 2018 and have less than a month to declare whether they’ll sell plans on ACA exchanges. A growing political fracas over cost-sharing reduction (CSR) payments is making that annual planning process difficult.
Previously, the Trump administration said it would continue funding CSRs while a lawsuit over them plays out. The case, brought originally by House Republicans against the Obama administration, argues that Congress never appropriated funding for CSRs, so the payments are unconstitutional.
Complicating the matter are reports that President Donald Trump was considering withholding the payments to force Democrats to the bargaining table over the GOP’s proposed ACA replacement and that Centers for Medicare and Medicaid Services Administrator Seema Verma sought political support from insurance companies for the American Health Care Act by offering a deal to continue funding the CSR payments.
Humana was the first major insurer to pull out of the exchanges entirely after this year. It announced in February that it will stop offering individual market plans in 2018.
Based on an initial analysis of its ACA exchange membership after the 2017 open enrollment period, Humana is “seeing further signs of an unbalanced risk pool,” CEO Bruce Broussard said at the time.
After pulling back its exchange offerings from 778 counties to 242 in 2017, Aetna said it would not participate in any health insurance exchanges in 2018.