Blue Cross Blue Shield may strike next big blow to exchange marketplaces

Photo credit: Getty/John Spannos

In the wake of high-profile insurer exits from Affordable Care Act exchanges, there are signs that Blue Cross Blue Shield plans may deliver the next big blow to the marketplaces.

Blue Cross and Blue Shield of Minnesota has already slashed its exchange offerings for 2017, saying the move was necessary given that it expects losses in its individual business segment to top $500 million over three years.

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Blue Cross and Blue Shield of North Carolina may be the next to bow out, with its CEO saying that the company will decide this month whether to continue participating in an ACA marketplace already vacated by UnitedHealth and Aetna, the Charlotte Observer reported.

Continuing losses on ACA plans may force many once-committed Blues plans to follow their publicly traded peers’ lead and rethink exchange participation, according to Robert Laszewski, president of consulting firm Health Policy and Strategy Associates. 

“These Blue Cross plans will stay longer, but they can’t stay forever,” he told The Hill.

Indeed, the Blue Cross Blue Shield Association reported this spring that following ACA implementation, Blues plans saw a spike in certain chronic conditions among their members that drove costs higher.

Rate hikes also might not solve the problem, Laszewski notes. If, for example, Blue Cross Blue Shield of Texas raises premiums 60 percent, healthy consumers might respond by dropping coverage, which could contribute to further losses.

No two Blues plans are the same, however, BCBSA Senior Vice President of Policy and Representation Alissa Fox told The Hill. Each insurer, she said, is independently evaluating the public exchange situation while remaining committed to the communities they serve.

Blue Cross Blue Shield of Arizona, for example, recently announced it will offer coverage in Pinal County, Arizona, which previously was set to have no exchange options next year. But the organization is far from optimistic: CEO Rich Boals noted in a statement “BCBSAZ is trying hard to balance the company’s financial losses from the ACA with the very real concerns of Arizonans.”

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