Blue Cross and Blue Shield is North Carolina’s largest health insurer by far and has worked assiduously for years to keep it that way. But nowadays Blue Cross is chiding its competitors for opting out of selling subsidized health coverage here on Blue Cross’s turf.
The corporate message, posted on Blue Cross’s web site a week ago, is designed to “out” the insurance companies for not signing up North Carolina customers. The site says the customers these insurers are dodging “are likely to be in poorer health than others” and prone to run up medical bills.
Blue Cross even names the six health insurance companies that don’t sell subsidized coverage on the federal marketplace here: Aetna, Cigna, Humana, UnitedHealthcare, Assurant Health and Celtic. The sextet of insurers does sell conventional health insurance, however, to those who have always been able to get insurance in the past.
“All were invited to the dance,” explained Blue Cross spokeswoman Michelle Douglas. “We were the only ones who showed up willing to serve everyone.”
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Douglas said the message is for customers who are frustrated for lack of choice and see Blue Cross as a monopoly.
“Blue Cross has a good point,” said Adam Linker, a policy analyst with the N.C. Justice Center, and a frequent Blue Cross critic. “They are taking all the risk in every county.”
There is one competitor Blue Cross has not named: Coventry Health Care of the Carolinas. Coventry offers subsidized coverage in 39 counties, but Blue Cross offers it in all 100 counties in the state.
The pool of residents thought to be eligible for subsidized coverage is estimated to exceed 1 million people in North Carolina. Through December, about 108,000 have signed up.
It remains unclear how many customers Blue Cross and Coventry have signed up since enrollment began in October.
The large insurers Blue Cross named do participate in subsidized markets in other states. They have said in the past they limited the states in which they’d participate in the first year of the health law, commonly called Obamacare, but could enter the North Carolina market at some point.
“They elected to cherry pick the business they thought would be most profitable for them,” Douglas said. “If you’re not on the exchange then you’re not serving those customers who require a subsidy, which is a large swath of North Carolina residents.”