CareFirst, D.C. officials at odds over exchange participation

A tense situation arose over the weekend between officials in Washington, D.C., which is implementing its own health insurance exchange, and CareFirst Blue Cross Blue Shield, the region's dominant insurer.

The issue stems from the number of plans CareFirst will sell on the exchange. It proposed a few weeks ago to offer 62 plans, but then said in a filing Friday it would sell only eight plans on the exchange. CareFirst said the 54 remaining plans would be available only to employers that don't use the marketplace, reported the Washington Business Journal.

District of Columbia Insurance Commissioner William White responded to CareFirst's filing by saying such few options would undermine maximum participation in the exchange. "At this point, they are gaming the system and it looks like a case of bait and switch," White said of CareFirst's "drastically limited options," according to The Washington Post. "CareFirst has a decision to make. Do they stand with the workers and business owners of the District of Columbia, or will they continue to put profits over principle?"

And Mohammad Akter, chairman of the exchange's executive board, told the Washington Business Journal that CareFirst was acting with "arrogance" and "childlike behavior."

After the officials issued statements about CareFirst's planned exchange participation, the insurer explained it hasn't scaled back its offerings, but rather the city officials misinterpreted its filing. It said the 54 plans will be sold both on and off the exchange, the Washington Business Journal reported in a follow-up article.

"Much of the information that has been promulgated is neither correct nor reflects CareFirst's intent in making these filings," CareFirst said in a statement. "Our intent has been to offer this array of products both on and off the health benefits exchange, and it is unfortunate the information published does not correctly reflect our intent."

To learn more:
- read the Washington Business Journal article and follow-up article
- see the Washington Post article

Suggested Articles

Data and analytics company Health Catalyst reported its Q2 results the same week it announced some major deals.

After eleven straight quarters of reporting positive earnings, Highmark’s AHN saw million in losses in the first half of the year due to COVID-19.

One Medical plans to expand into North Carolina and Wisconsin as the primary care providers' membership grows during the COVID-19 pandemic.