Blue Cross Blue Shield of Texas, facing massive losses for its ObamaCare plans, has requested a 58% premium hike for 603,000 customers.
The company is pricing in the claims experience of customers that’s been far higher than expected after suffering a $770 million loss on its exchange plans in 2015, equal to 26% of premiums.
Overall, individual market insurers requested a 35% ObamaCare premium hike for about 1.3 million customers, calculated ACASignups.net, based on the full range of insurer filings available.
BCBS of Texas also is seeking an 18% increase for 353,000 members who buy plans via the small group market that caters to businesses with fewer than 50 employees.
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News that a CareFirst BlueCross BlueShield subsidiary will stop selling bronze level plans on the Virginia marketplace next year prompted some speculation that it could signal a developing movement by insurers to drop that level of coverage altogether. The reality may be more complicated and interesting, some experts said, based on an analysis of plan data.
Bronze plans provide the least generous coverage of the four metal tiers offered on the insurance marketplaces, paying 60 percent of benefits on average, compared to 70 percent for silver plans, which are far more popular. During the 2016 open enrollment period, 23 percent of marketplace customers signed up for a bronze plan, compared with 68 percent who chose silver, 6 percent who picked gold and 2 percent who chose a platinum plan.
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The House Oversight Committee released a report Wednesday detailing extreme misconduct surrounding Oregon’s failed $305 million taxpayer funded Obamacare exchange and is calling on the Department of Justice to open a criminal investigation.
“The documents and testimony show Oregon State officials misused $305 million of federal funds and improperly coordinated with former Governor John Kitzhaber’s campaign advisers. Official decisions were made primarily for political purposes. Cover Oregon was established as an independent organization by the legislature, and was not intended to be a wholly controlled subsidiary of the Governor’s political apparatus,” House Oversight Committee Chairman wrote in a letter sent to Attorney General Loretta Lynch and Oregon Attorney General Ellen Rosenblum.
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ObamaCare premium increases will be higher than last year, according to a new analysis of early data.
The analysis from the consulting firm Avalere Health finds that proposed ObamaCare premiums for silver-level plans are increasing an average of 16 percent in nine states that so far have complete data.The proposed increases for silver plans, the most popular, vary widely, from a 44 percent average increase in Vermont to a 5 percent increase in Washington state.
The increases appear to be higher than last year on average. An Avalere analysis at a similar point in the process last year found an average increase of about 6 percent.
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Smaller insurers with experience in Medicaid, such as Centene Corp. and Molina Healthcare, are outperforming the broader insurance industry on the federal health exchanges. Their success is putting a spotlight on their business model as the Obama administration and other insurers seek to stabilize the fledgling individual market.
If Medicaid-like plan features become the norm, consumers and medical providers would be substantially affected. Such plans are often popular in the exchanges for their low premiums, but consumers have criticized limits on their access to medical providers such as doctors. And physicians fault the plans for low reimbursement rates.
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Health insurers have not had much to cheer about lately, when it comes to Obamacare. They have been losing money on exchanges, and there is little hope that will change. So, a large health plan in Pittsburgh has asked judges to give it Obamacare money the Administration promised, but Congress declined to appropriate.
As reported by Wes Venteicher and Brian Bowling of the Pittsburgh Tribune-Review, Highmark lost $260 million on Obamacare exchanges in 2014, and claims it is owed $223 million by taxpayers. Unfortunately, it received only about $27 million. And things are getting worse. To date, Highmark has lost $773 million on Obamacare exchanges.
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Oracle has had enough of Oregon. The business technology giant has decided it will no longer take on new business with the state’s government amid an ongoing legal battle, Oracle senior vice president Ken Glueck told Fortune on Wednesday.
The decision follows a protracted legal tussle between the two parties over a disastrous state healthcare enrollment website that never came online. In 2011, Oregon enlisted Oracle to build a healthcare exchange website related to Obamacare after being impressed by the company’s sales pitch, according to a previous legal filing.
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Enrollment in individual health care plans, now dominated by the Affordable Care Act exchanges, fell 15.4 percent in the first quarter for the parent of Blue Cross and Blue Shield of Illinois.
At the end of March, Chicago-based Health Care Service Corp. had 1.39 million individual members, compared with 1.64 million as of Dec. 31.
The decline in individual members is even greater when compared with the first quarter of 2015. A year ago, HCSC had nearly 1.9 million individual market members.
Despite the decline in individual enrollment, the insurer set aside $431.5 million in reserves during in the first quarter to account for losses expected in its 2016 ACA business, according to first-quarter financial statements filed this week with the Illinois Department of Insurance.
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Top Republicans on the House Energy and Commerce Committee sent letters this week seeking more information about the financial status of the 11 remaining co-ops created under the Affordable Care Act.
Reps. Fred Upton (R-Mich.), Tim Murphy (R-Pa.) and Joe Pitts (R-Pa.) say they want to better understand the financial challenges the co-ops are facing and ensure the Centers for Medicare and Medicaid Services is taking the “necessary and appropriate steps” to keep the co-ops functioning. The agency has placed eight of the remaining co-ops on corrective action plans, and 12 had closed by the start of 2016.
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