BCBS of North Carolina might exit ACA marketplace

Following in the footsteps of two of the country's largest insurers, Blue Cross and Blue Shield of North Carolina may consider leaving the Affordable Care Act marketplace in 2017.

The insurer said earlier this month that it expects to lose more than $400 million on its ACA policies for 2014 and 2015. Even though BCBSNC raised its rates 32.5 percent this year, CEO Brad Wilson said that still couldn't keep the insurer from losing money on its exchange products, the News & Observer reports.

Therefore, BCBSNC might decide later this year whether it would be wisest to stop selling ACA policies. "We can't offer something for sale in this marketplace that we know every time it's purchased we're losing money," Wilson said during a meeting with the newspaper's editorial board and editors.

UnitedHealth was the first major insurer to announce it was reconsidering its ACA marketplace participation, and Humana indicated it also is mulling an exit in its fourth-quarter earnings report. What's more, Blues plans nationwide spent more on medical claims for their individual market policies than they collected in premiums during the first three quarters of 2015.

If BCBSNC does pull out of the marketplace in 2017, more than 300,000 people would need to look for new coverage, the News & Observer notes. North Carolina Insurance Commissioner Wayne Goodwin told the newspaper that BCBSNC will have to decide its strategy based on the rate increase that his agency approves for next year.

Last week, Goodwin sent a letter to Department of Health and Human Services Secretary Sylvia Mathews Burwell that detailed his worries about the viability of the state's ACA marketplace. "I am highly concerned insurers may withdraw from the individual market in North Carolina altogether," he wrote.

ACA-related losses also are not the only problem that BCBSNC has on its hands. The insurer continues to grapple with a massive IT system failure that resulted in dropping coverage for and over billing customers.

To learn more:
- read the News & Observer article

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