BCBS CEO: High-risk exchange customers create unsustainable losses

Sicker, more expensive patients are flooding the Affordable Care Act exchanges in North Carolina, driving up medical costs for insurers and creating "unsustainable" losses, Blue Cross Blue Shield of North Carolina president and CEO Brad Wilson told the Charlotte Business Journal.

Echoing concerns he voiced earlier this year, accompanied by hints that the insurer might leave the ACA marketplace altogether, Wilson said BCBSNC spent $1.3 billion in medical claims on ACA consumers in 2015 who are sicker and more expensive than many anticipated. Earlier this year, BCBSNC reported a $400 million loss on exchange plans in 2014 and 2015. Overall, Blue Cross Blue Shield plans have reported higher rates of chronic illness among members compared to previous years.

While citing rising costs for medical and pharmaceutical services, Wilson indicated the risk pool for exchange plans needs to be bigger in order to offset the state's sickest incoming patients. He also advocated for tightening special enrollment periods, which some experts have blamed for increasing premiums.

For more:
- read the Charlotte Business Journal article

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