Premera will offer individual health plans in GH
Premera Blue Cross has said it will offer individual health insurance to people living in Grays Harbor County in 2018. Just last week, none of the 11 carriers operating in Washington were willing to offer coverage to county residents who weren’t part of a group coverage plan.
“Following repeated discussions, I am pleased that Premera Blue Cross has decided to offer two individual health plans to consumers in Grays Harbor County in 2018. This is welcome news for that community,” Washington state Insurance Commissioner Mike Kreidler said.
“The plans will be offered through the Washington Health Benefit Exchange, where consumers who qualify can get subsidies to help pay their premiums.”
Premera’s proposal includes a 27.7 percent increase from its current rates.
Virtually every one of the 11 insurance carriers is proposing premium increases. The statewide average is a 22.3 percent hike, the highest being Molina Health Care of Washington at 38.5 percent.
Kreider called the proposed increases “upsetting” and said, “We’re going to spend the next several months reviewing every assumption insurers have made to make sure their proposed increases are justified.
“There is a great deal of uncertainty underlying our country’s health insurance system today and no state is immune. There are specific issues with our health insurance system that we need to address, such as the rising costs of prescription drugs and health care services. Yet, the current federal administration’s actions — such as not committing to reimburse insurers for cost-sharing subsidies and not enforcing the individual mandate — appear focused only on destabilizing the insurance market. Sadly, it’s the people in our communities and across the country who will pay the price.”
All rates, health plans and coverage areas are under review and may still change. The coverage is to be certified by Sept. 14 and open enrollment for the 2018 individual market starts Nov. 1.
The Premera coverage for Grays Harbor and the rest of the state will only be offered through the state’s exchange program, whether the insured receives subsidies through the state, or whether they pay the full rate themselves.
Insurance carriers had until June 7 to register their plans with the state and as of that date, two counties — Grays Harbor and Klickitat — drew no interest. Kreidler said he is still working on coverage for Klickitat.
His office estimated that if no carrier came forward to offer plans on Grays Harbor, at least 2,200 people were likely to lose their health insurance for 2018.
Speculation on the carriers’ decision in the case of Grays Harbor centered on the county’s consistently poor showing when chronic health problems are measured.
Kreidler reportedly asked all the carriers what their obstacles were for coverage in the two counties. The carriers were invited to a work session Monday in Olympia.
Asked what happened to make Premera rethink its decision, Kreidler said one factor had to do with his office signaling that it might be willing to accept some financial information from the carriers on a confidential basis when rate proposals are scrutinized for 2019. The information would be reviewed by a consultant, he said.
But he also had positive things to say about Premera in general. “When it came to the Affordable Care Act, they jumped in with both feet,” said Kreidler. “Not all insurers did. They have a very strong commitment … and realized that their departure from Grays Harbor created a real problem. … I think they were just prepared to rethink it.”
Kreidler said legislators from the 19th and 24th districts serving Grays Harbor, along with Congressman Derek Kilmer, were helpful in moving Premera.
Rep. Jim Walsh, R-Aberdeen, on Monday introduced a bill called the Washington Patient Choice Restoration Act, HB 2228.
The Washington Health Benefit Exchange was intended to increase the availability of coverage through the private health insurance market, but a number of factors including poor-health rankings in some regions, heavy financial losses by insurance carriers, and the uncertainty of the future of the exchange, have led many insurers to withdraw from offering coverage in rural counties, Walsh said, with the result being a significant decrease in carrier participation, leaving some rural residents with few, if any, options for coverage.
Under Walsh’s proposal, state market rules would no longer require insurers who offer “bronze” plans outside of the exchange to also offer “silver” and “gold” plans. These same state-only mandates would also be reformed to allow greater flexibility in the sale of catastrophic plans. These requirements would only be exempt if they did not violate federal law.
Source: The North Coast News