Insurers' public exchange retreats continue in Tennessee, Indiana

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Two more insurers are scaling back their Affordable Care Act participation, joining the growing ranks of payers that have expressed doubts about the exchanges' sustainability.

BlueCross BlueShield of Tennessee (BCBST) will scale back its marketplace participation, and Indiana University Health Plans will exit the public exchange market. Combined, the moves impact an estimated 127,000 people who will now be compelled to find new health plans for 2017.

BCBST said it will reduce marketplace participation from eight counties to five, impacting an estimated 100,000 Tennesseans in the Memphis, Nashville and Knoxville areas, according to an announcement. The insurer said it lost almost $500 million on its ACA plans.

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2019 Drug Pricing and Reimbursement Stakeholder Summit

Given federal and state pricing requirements arising, press releases from industry leading pharma companies, and the new Drug Transparency Act, it is important to stay ahead of news headlines and anticipated requirements in order to hit company profit targets, maintain value to patients and promote strong, multi-beneficial relationships with manufacturers, providers, payers, and all other stakeholders within the pricing landscape. This conference will provide a platform to encourage a dialogue among such stakeholders in the pricing and reimbursement space so that they can receive a current state of the union regarding regulatory changes while providing actionable insights in anticipation of the future.

BCBST's announcement comes in the wake of news that Blue Cross Blue Shield of Nebraska will pull out of the ACA marketplace and Blue Cross Blue Shield of Minnesota will lessen its participation. North Carolina’s Blues plan, though it has also cited losses on ACA plans, decided to stick it out on the exchanges at least one more year, FierceHealthPayer reported Monday.

For its part, IU Health Plans said that although state regulators approved its request to increase premiums an average of 14.9 percent, heightened financial uncertainty and moves such as UnitedHealth's exchange pullback factored into its decision to exit Indiana’s exchange, according to the Indianapolis Business Journal. IU Health Plans had covered about 27,000 people under its ACA policies as of June.

Under pressure from health insurers' exchange withdrawals, in late August President Barack Obama responded with proposed changes to the ACA that would strengthen proof of eligibility for special enrollment period enrollees, restructure the way medical loss ratios are calculated, and end the rule banning insurers from entering marketplaces for five years if they had previously left, among other policies.

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