Iowa: Wellmark still doing the Hokey-Pokey, jumping back into the exchange again next year
2019 OPEN ENROLLMENT ENDS (most states)
Time: D H M S
Wellmark spurns Obamacare exchange, but two competitors don't
Moderate-income Iowans who want to use Affordable Care Act subsidies to purchase health insurance still won't be able to choose policies from Wellmark Blue Cross & Blue Shield next year. But they should be offered policies from at least two competitors.
Iowa’s dominant health insurer has agreed to start selling policies a year from now that qualify for Obamacare subsidies.
Wellmark Blue Cross & Blue Shield has not participated in the Affordable Care Act’s online health insurance marketplace, which launched in the fall of 2013. The main effect of the company’s decision was that moderate-income Iowans could not choose Wellmark insurance if they wanted to purchase policies that qualified for new federal subsidies to help pay premiums.
Other insurers have participated in the marketplace, also known as an exchange. Three carriers are selling policies statewide for 2016. Wellmark announced Monday that it will start selling policies on the marketplace for 2017, because the online system has become more reliable and because the legality of the federal subsidies has been upheld by the U.S. Supreme Court.
In Iowa, Wellmark will no longer offer gold tier plans and will not promote individual under-65 plans that use its Preferred Provider Organization (PPO) network in Iowa. Individual ACA members with a silver or bronze PPO currently may continue on that plan for 2017, however. The changes won't affect people with grandfathered or grandmothered plans (generally those who purchased their individual plans prior to Jan. 1, 2014).
...Wellmark said it will also move forward in 2017 with plans to introduce a new HMO plan for the individual ACA market called Blue Simplicity, which will offer a simplified copay option.
Wellmark to halt sales of individual health insurance policies
Iowa’s dominant health insurance company has decided to quit selling individual policies because of tumult in the market stemming from the Affordable Care Act and Republicans’ failed effort to replace it.
...Now, President Donald Trump's administration has decided not to enforce the Obamacare penalty for Americans who fail to obtain health insurance. That makes the situation even worse, Forsyth said.
...If carriers want to sell individual insurance for 2018, they have to submit proposed rates by June. But they don’t yet know what the rules will be, Cox said. “That uncertainty makes insurers very nervous,” she said.
...Forsyth said his company hopes to re-enter the individual market in the future, but it has firmly decided to stay out for 2018. He made several recommendations for how government leaders could stabilize the market.
Wellmark to return to Iowa exchange, sell ACA-compliant plans
Company will offer individual policies in 2019
Wellmark Blue Cross and Blue Shield is back.
A little more than a month after the Des Moines-based insurer left the state’s insurance exchange, Wellmark will return in 2019 to sell Affordable Care Act-compliant plans on and off the exchange, the company announced Thursday.
“We are predisposed to want to be in this market, so we need just enough certainty to allow us to be there and we think we now have that,” Cory Harris, executive vice president and chief administrative and legal officer, told The Gazette Thursday.
There's one big caveat here, of course...
The company will offer fully ACA-compliant plans on the public exchange in all 99 counties beginning Jan. 1, 2019, “assuming there aren’t any significant changes to the Affordable Care Act,” stated a news release from the company.
Company officials said more stability in the ACA market allows Wellmark make a to return, Harris said.
“Remember last year in Washington, it was all about repeal and replace, which left our company with a lot of uncertainty about the viability about this particular market segment,” Harris said. “A lot of that has seemed to have subsided to some degree.
“That regulatory uncertainty has dissipated just enough that we think we’re able to step back in and serve the market segment that we had historically been in and we want to be in.”
UPDATE: Thanks to Amy Lotven for bringing this tidbit to my attention from the actual Wellmark press release announcing their return to the ACA exchange:
Therefore, today we are announcing several options to provide individual and family coverage in Iowa. Our members, our agents, and most recently Governor Kim Reynolds and Iowa Insurance Commissioner Doug Ommen, have asked Wellmark to offer individual and family coverage in this market.
To that end, we will offer fully ACA-compliant products on the public exchange for 2019, assuming there aren’t any significant changes to the Affordable Care Act. We will also explore offering additional options outside of the ACA for Iowans, if state and federal rules allow us to do so.
While there is no singular solution to stabilize the entire individual market in 2019, Wellmark will seek to offer options that provide more choice and affordability to Iowans than they have today. Wellmark believes the individual market can be functional once again. We pledge to continue working with state and federal officials, business partners, and other stakeholders to find a solution for all Iowans in the individual and family insurance market.
Well, now...that's pretty ominous. Sounds to me like Wellmark may be in cahoots with the Governor & Insurance Commissioner to try and push something along the lines of what Idaho Governor Butch Otter (yes, that's the name he goes by) is trying to pull. That might explain their sudden about-face on jumping back into the exchange in the meantime. Then again, it might not be anything as nefarious as that. Stay tuned...