Health Care

Blue Cross plans to offer ACA plans in all 100 NC counties in 2017

A client enters the Blue Cross Blue Shield of North Carolina Triangle Sales Center in the Village Market Place shopping center in Morrisville, NC, in a file photo taken Saturday, January 9, 2016.
A client enters the Blue Cross Blue Shield of North Carolina Triangle Sales Center in the Village Market Place shopping center in Morrisville, NC, in a file photo taken Saturday, January 9, 2016. hlynch@newsobserver.com

Blue Cross and Blue Shield, North Carolina’s largest health insurer, said Thursday morning that it plans to continue offering individual coverage under the Affordable Care Act in all 100 counties of the state in 2017.

The announcement guarantees that all North Carolina residents will have ACA access to at least one insurer next year as the federal exchange enters its fourth year of public enrollment. Blue Cross’s decision comes after two major insurers – Aetna and UnitedHealthcare – said they would suspend sales of ACA plans in North Carolina and many other states in 2017.

“Without BCBSNC in the Marketplace, 600,000 North Carolinians would be at risk of losing their coverage,” Blue Cross said. “With the national insurers officially exiting the market, BCBSNC will absorb about 260,000 more customers than expected.”

What remains unclear is how much Blue Cross will raise rates next year.

Pricing and other details of Blue Cross insurance plans will not be released until October. The company had requested an 18.8 percent average rate increase for 2017 plans from the N.C. Department of Insurance, after being granted a 32.5 percent average rate increase for 2016 plans. But Blue Cross has since revised its initial request after Aetna and UnitedHealthcare withdrew.

“As a result, we adjusted our rate filing for 2017 to account for the influx of new customers and their medical needs,” Blue Cross said. “Existing customers can expect rate notices in their mailboxes by the end of October to learn more about how these changes will impact them.”

The only other insurer to offer ACA plans in the state will be Cigna, which plans to start out with a Triangle coverage area limited to Chatham, Johnston, Nash, Orange and Wake counties.

ACA coverage is sold to individuals online or through an insurance agent. Most Americans obtain health insurance through an employer or a federal program like Medicare or Medicaid.

Blue Cross has offered ACA plans statewide since 2014, the first year that Americans had individual health insurance coverage through federal exchanges. The Durham-based organization had said it would review whether to offer ACA plans in 2017 after losing $405 million on medical expenses for ACA customers in 2014 and 2015.

The company said it’s been forced to raise rates and restrict provider networks as a way of controlling costs from ACA customers, who tend to be sicker and older than the general population.

“We’ve heard from many of you that the cost of premiums remains a top concern when shopping for a subsidized plan,” Blue Cross said. “At the same time, we’re learning just how much ACA customers use medical services – and it’s a lot. This wouldn’t be a great concern if enough healthy customers were paying into the system to offset these costs.”

Open enrollment for 2017 will begin on Nov. 1, and will end Jan. 31. Customers who want health insurance by Jan. 1 will need to be enrolled by Dec. 15.

The ACA, passed by Congress in 2010, requires most Americans to have health insurance or pay a financial penalty. The federal program offers financial subsidies to offset health insurance expenses for people whose household incomes fall between 100 percent and 400 percent of the federal poverty level, typically low- and middle-income households.

In North Carolina, ACA enrollment surpassed 545,000 people as of March 31, the fourth-highest ACA enrollment in the United States.

John Murawski: 919-829-8932, @johnmurawski

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