Minnetonka, Minn.-based UnitedHealthcare’s departure from the ACA exchange in 2017, along with Knoxville, Tenn.-based Consumers’ Choice Health Plan’s closure last year, left one large private insurer — Columbia-based Blue Cross Blue Shield of South Carolina — with reign of the market in 2017. (Hartford, Conn.-based Aetna will also offer plans in 14 out of the state’s 46 counties next year).
For more than 220,000 individuals in South Carolina insured through the ACA exchange, insurers’ departures and closures mean some consumers will only see two coverage choices next year — BCBSSC and its subsidiary BlueChoice HealthPlan. While the state’s Department of Insurance said prices will not skyrocket, some experts in healthcare question the viability of the ACA in South Carolina.
“The way it’s going right now, it’s probably going to implode in the next year or two,” CEO of the Medical University of South Carolina Pat Cawley, MD, said. The Post and Courier reported MUSC loses millions of dollars each year because MUSC Health is not in BCBSSC’s network.
Jim Ritchie, executive director of South Carolina Alliance of Health Plans, agreed, saying without reform, the ACA marketplace could falter. As insurance companies cannot deny consumers with pre-existing conditions, they often suffer losses from sicker and older consumers.
Ray Farmer, director of the South Carolina Department of Insurance, said it is no secret payers are facing hardship on the federal marketplace. Mr. Farmer did not say which payers will be on the exchange next year, though that information will be made public in the fall, according to the report.
More articles about payer issues:
Aetna to auction $1B in assets
Ky. governor’s proposed Medicaid reform largely criticized
Wyoming sees 11% increase in ACA exchange enrollees
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