Executives at the nation’s Blue Cross and Blue Shield plans say they are committed to covering individuals on public exchanges under the Affordable Care Act even as the nation’s largest health insurer said it might pull off the government online marketplaces by 2017.
UnitedHealth Group CEO Stephen Hemsley said costs of treating patients who purchase coverage on exchanges is mounting with sick individuals leaving expensive claims to pay. UnitedHealth lowered its earnings forecasts due to slow growth in the business of selling individual policies on “public exchanges.”
But UnitedHealth’s more dominant competitors in the business of selling individual commercial policies say they are staying. Unlike UnitedHealth, Blue Cross plans have had insurance products on exchanges in most U.S. states since 2014 and UnitedHealth was a late entrant in 24 states, including the 11 markets it said it would add in 2016.
“As a customer-owned company, our primary goal is to expand access to health insurance to as many people as possible in the states we serve,” said Greg Thompson, a spokesman for Health Care Service Corp., which is a mutual insurance company owned by policy holders that operates Blue Cross and Blue Shield plans in Illinois, Texas, Oklahoma, New Mexico and Montana.
In Illinois, Health Care Service’s biggest market, the Blue Cross and Blue Shield plan has more than 80% market share among individuals who purchased coverage on the exchanges. UnitedHealth only entered the Illinois market in the last year and has a fraction of the state’s individual “on exchange” business.
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“From the start, we vowed to leave no community behind and have consistently offered products in every county of every state,” Thompson said. “To sustain our mission of equal access to health insurance for all communities, we have worked hard to adapt our networks, focus on quality outcomes and educate people how to maximize the value of their benefits. Affordability, quality and access for all communities are our objectives today and in the future.”
The individual commercial insurance business isn’t without its challenges and several companies say health plans are lucky to break even given Americans buying on the public exchanges tend to be older and sicker.
UnitedHealth’s rivals have had to raise rates by double-digit percentages in certain markets and reduce customer access to plans, instead offering narrow networks of doctors and hospitals. HCSC’s New Mexico plan is one such outlier for the company and said it will no longer offer “on exchange” coverage after a rate increase was denied by that state’s insurance commissioner.
But the largest operator of Blue Cross and Blue Shield plans also expressed its commitment to public exchanges following UnitedHealth’s announcement.
On Friday, Swedish reiterated Anthem’s commitment to the individual insurance business under the health law in the 14 states where it operates under the Blue Cross and Blue Shield plan. Anthem is also poised to grow in additional markets should its pending acquisition of
“As a leader during this time of unprecedented transformation in healthcare, Anthem remains committed to enhancing access to high quality, affordable healthcare for all of our members inside and outside of the insurance exchanges and continuing our dialogue with policymakers and regulators regarding how we can improve the stability of the individual market,” Swedish said in a statement the company issued Friday. “Since the launch of the insurance exchanges, Anthem has offered more than 1,000 new insurance product choices in 14 states across the country – more than any other healthcare insurer. Today, we serve more than 1.7 million individuals with our trusted and caring solutions.”
