ComPro – Nebraska’s Individual Health Insurance Market In Trouble

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Nebraska’s Individual Health Insurance Market In Trouble

A May 12th article by the Washington Post* pointed out that Nebraska and Iowa are leading the nation in the demise of the individual market. “The insurance markets in two states [Nebraska & Iowa] are now hanging by a thread, held together at this moment by a small, Midwestern plan [Medica] that most people had never heard of before,” said Larry Levitt, a vice president at Kaiser Family Foundation. “The big national insurers have essentially abandoned the marketplaces, and they were very skeptical to begin with.”

In 2017, Nebraskans could select from Medica or Aetna if their health insurance was purchased through the Marketplace ( BlueCross BlueShield was also available to those who did not use the Marketplace because the company decided to withdraw from offering Marketplace plans. United Healthcare withdrew at the end of 2016. Now Aetna has announced their withdrawal from Nebraska for 2018 and will not offer any individual insurance products.

That leaves only Medica remaining on the Marketplace for 2018 with BlueCross BlueShield as a second option for off-Marketplace coverage. Neither of these companies have announced their intentions for 2018. Insurance companies must file their preliminary rates for 2018 with the Department of Insurance by June 15th. Final rates and a decision to participate will be determined in September 2017. indicates that 84,371 Nebraskans enrolled in a plan through for 2017. Their options for next year are very unclear. The issue for the insurance companies is financial. They are losing money on individual health insurance policies. Part of the reason is that the federal government has not paid all the CSR subsidies. Another issue is the number of high-dollar claims that are being paid.

If Medica stays, the company will essentially be assuming all the risk for the medical expenses of those 84,000+ people. In traditional insurance risk management, that burden is shared by all the companies that are participating in a market. That change in the assumed risk will likely translate into higher premiums – again!

We need help from our elected officials. The American Health Care Act passed by the House of Representatives and legislation being considered by the Senate focus on longer-term solutions that would not be implemented until 2020 and beyond. Until then, other measures are needed to stabilize the individual health insurance market for 2018 and 2019. If you are concerned about your access to health insurance and the cost of your monthly premium, let your state and federal legislators know.


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