BCBS of Minnesota pulls back from individual market

Downward arrow superimposed in front of money

In a move that deepens worries about the stability of the Affordable Care Act exchanges, Blue Cross and Blue Shield of Minnesota will drastically pare down its participation in the individual market for 2017.

BCBSM said losses in its individual segment are expected to top $500 million over three years, forcing it to stop offering most individual and family plans starting in 2017. The state’s largest health insurer said its individual plans will be limited to its Blue Plus HMO, an accountable care organization with 13,000 members that will remain available through the state’s health insurance exchange, MNsure.

“The individual market remains in transition and we look forward to working toward a more stable path with policy leaders here in Minnesota and at the national level,” Blue Cross said in its announcement. “Shifts and changes in health plan participation and market segments have contributed to a volatile individual market, where costs and prices have been escalating at unprecedented levels.”

Blue Cross losses on individual market plans in 2015 alone were $265 million, Minnesota Public Radio reported. The insurer will continue to offer group plans through employers.

Democratic Gov. Mark Dayton said in a statement that because employers and public health insurance programs provide most health insurance coverage, Minnesotans in the individual market tend to have greater healthcare needs than the general population. “Blue Cross Blue Shield's decision to leave the individual market is symptomatic of conditions in the national health insurance marketplace,” he said.

About 20,000 Minnesotans purchased Blue Cross and Blue Shield of Minnesota plans through the state’s health insurance exchange, MPR reported. Most qualified for tax credits. Overall, BCBSM’s changes will affect 103,000 customers, the insurer said.

Dayton noted in his announcement that 213,000 previously uninsured Minnesotans obtained healthcare coverage through MNsure over the past three years, cutting the uninsured rate in half to the second-lowest in the nation. Blue Cross’ decision to pull out of the individual market “will not imperil that progress,” he said.

Blue Cross of Minnesota’s decision comes after UnitedHealthcare announced in 2017 it will exit most state insurance exchanges in which it operated, citing heavy financial losses. Humana also is drawing down its participation.

To learn more:
- here’s the Blue Cross announcement
- check out the governor’s announcement
- read the MPR article