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Blue Cross Blue Shield plans ACA exits in two states

by Thomas Dworetzky , Contributing Reporter
The Affordable Care Act's coverage faces another challenge as Blue Cross and Blue Shield announced it will pull out of three markets in Tennessee and Nebraska in 2017.

In taking the dramatic steps it joins Aetna, Humana and United Healthcare, all of which are also looking to cut back involvement in some markets next year.

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“We cannot take another hit,” Steve Martin, Blue Cross CEO, told the Omaha World-Herald. “We are very hopeful and will work with federal regulators with positive intent and try to be back in the marketplace next year. But if the markets are worse or don’t change, we can’t guarantee we’ll be back.”

BCBS has only about 20,000 policies for the individual exchange out of the 750,000 in the state. But those have led to $140 million worth of losses from 2014 to the present – and could have led to $250 million if the insurer had stayed in the marketplace through 2017. BCBS's coverage of employee groups, Medicare and Medicaid and other pre-ACA policies will remain unchanged. Higher benefit BCBS policies in the state obtained outside of the exchanges will also be dropped as they have been losing money, the company told the paper.

“We had to think long and hard about the effect on our company,” Blue Cross President Lew Trowbridge told the publication. “I mean, enough’s enough, and $140 million is a lot of money to us. We don’t see it ending, so we have to take corrective action now, as much as it pains us.”

One of the main issues raised by Martin is that the law lets people buy insurance just prior to needing high-cost treatments and then drop coverage.

“We believe the Affordable Care Act can be fixed, and we hope, post-presidential election, that whoever gets elected president and whoever is leading both sides of the aisle [in Congress] will come together and concentrate on making some fixes on this,” he stressed.

Research has demonstrated that the ACA works best in those states in which lawmakers expanded Medicaid – which Nebraska refused to do.

In Tennessee, the insurer is leaving the three largest exchanges – Nashville, Memphis and Knoxville. Calling the move “an extremely difficult but necessary decision," Roy Vaughn, chief communications officer of BCBS in Tennessee, told the Tennessean that, "In our rate request we took great care to close the gap between premiums and costs. We feel like we’ve adequately addressed that, but uncertainties at the federal level could still put us in a loss position even if our experience with the group is better and our rates better reflect our medical costs.”
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