Anthem Exit

It’s been three weeks  since the watershed announcement by Anthem Blue Cross to exit the Healthcare Exchange Insurance market in Virginia.  Insurance carriers hate uncertainty, and during the last five years, uncertainty has dominated the Affordable Care Act (ACA) discussion.  Insurance carriers were promised 48 million new customers in 2010, yet the penalties were so minor, most folks opted to pay the penalty.  Insurance carriers were promised that their risk pools would be healthy, and will stabilize within three years, yet most carriers have been left with a much older, sicker population.  With each rate increase, the pool deteriorates even further.

Insurance carriers were promised risk corridor reimbursements during the first three years, employers paid the excess costs to fund the reimbursements, yet the Republicans with a stroke of a pen decided not to fund them.  Insurance carriers were promised a “Repeal and Replace” option that would create a better market, yet the Republicans failed to garner enough votes in the Senate.  

Insurance carriers were promised that the current piece of legislation which includes premium tax subsidies for folks who qualify financially, and cost reduction subsidies which allow the lower income participants to have insurance with affordable deductibles and out of pocket limits, would continue – yet the rhetoric in Washington is to defund tax subsidies.  

So with Anthem’s announcement, we have only one remaining insurance carrier in our market; (Optima Health).  Will they change their minds and decide to exit the state?  If they remain a viable option, where will they sell their product and at what price?  Does Optima Health decide to “throw in the towel’ and put the final nail in the ACA coffin in Virginia.  

As a Muneris client, we will continue to keep you posted, but encourage you to be proactive as we approach the Open Enrollment Period which begins on November 1st.  Examine your spousal options if available, check with your employer to see if you are eligible for health insurance,  and if you are a business owner – let’s talk about buying insurance through your business.  

Lastly, we encourage you to have a conversation with your local politician who either voted for the ACA, or failed to garner enough votes to repeal the law.  It’s a colossal mess in Washington, and not enough time to create a workable solution for healthcare coverage for 360,000 Virginians who may lose their coverage in four months.

Burman S. Clark

Burman S. Clark, RHU, CSA is the President of Muneris Benefits and a licensed insurance broker and consultant. His independent practice and focuses on employee benefits, individual life, disability, medical, and senior products. Burman has traveled extensively and provided guidance to large employer associations with regards to the Affordable Care Act.