Blue Cross plans to re-enter the ACA market Insurer left the healthcare exchange in 2017 Exited since 2017, Blue Cross will re-enter the ACA market in Nebraska in 2023


Nebraskans who buy individual health insurance plans in the federal Affordable Care Act market will see a household name when they look at the listings for 2023 on the federal website.

After leaving the healthcare exchange in 2017, Blue Cross Blue Shield of Nebraska will re-enter the market next year with a new plan called Nebraska HeartlandBlue, which will be available to Nebraskas not covered by an employer health plan.

“We are delighted to be able to return,” said Ron Rowe, blue cross’ Executive Vice President. “Since we came out, we have been analyzing, trying to figure out when is the right time to go back. Now is the right time.”

For 2022, Nebraskans could choose from market plans offered by four insurers: Medical Health and Glowing Healthboth based at Minnesotaand newcomers 2022 Oscar, headquartered in New York Cityand Ambetter, of Nebraska Total Care.

That’s a change from 2018 and 2019, when Medica was the only insurer to offer plans on the exchange. The state started with four insurers offering plans when the exchange launched in 2014.

The full list of individual and small group plans that will be available on the exchange in 2023 is not yet available. The Nebraska Department of Insurance will provide individual and small group packages and rates October 31one day before the start of open registration November, 1st, according to a department spokeswoman. Open registration will continue until December 15.

Medica will participate in the exchange by Nebraska in 2023, according to a spokesperson. The insurer will also expand its network and plan its offerings for next year. By 2022, about half of Nebraskanians covered by the ACA had plans through Medica.

Rowe said blue cross exited the market due to the instability that led to losses of $140 million over three years.

Etna Healthwho also abandoned the Nebraska market in 2017, said at the time that he expected to lose more than $200 million in health plans Nebraska, Iowa and two other states that year.

In the first three years, insurers had to be paid based on three factors, Rowe said. During the second year, the federal government decided not to pay the second factor, which caused difficulties for all the insurers and a lawsuit which was finally settled by the Supreme Court.

Moreover, the penalties for not having insurance to begin with were supposed to be large enough to encourage healthy young people to participate in the market. But the penalties weren’t as substantial as expected and at one point weren’t enforced, Rowe said. Fewer young, healthy people participated than insurers had hoped, leaving older, sicker people who need more health care to make up the pools.

Political and regulatory uncertainty, with changing rules, has also made it difficult to plan or manage the business, he said. The company decided to exit the market to ensure that the losses do not spread and to force employers or Medicare members to subsidize the market pool.

Most of those concerns have now been resolved, he said, and the government has standardized the plans.

“Now the market is stable, so it’s time for us to come back,” Rowe said.

Consumers, healthcare providers and insurance brokers have also urged the company to re-enter the market, he said. About 60% of Nebraskanians who have ACA plans enroll through an independent insurance broker or agent. Nearly 1,000 brokers will be authorized to offer the gold, silver and bronze plans, and blue cross will begin broker training August 17.

Nebraska HeartlandBlue will be available in the 93 from Nebraska counties. During open enrollment or any special enrollment period for which they are eligible, Nebraskanians can visit or to purchase individual coverage.

Rowe said he could not discuss the rates because the proposed figures have not yet been approved by the State Insurance Department and CMS.

“We think we’re going to be very competitive,” he said.

According to a non-partisan analysis Kaiser Family Foundation, from Nebraska the average individual market benchmark premium in 2022 was $595. The WE the average was $438. Only five states had higher ones. However, from Nebraska The 2022 benchmark premium was down from a peak of $838 in 2019.

Rowe said the listing on the market in Nebraska is expected to increase to around 100,000 next year. If enrollment continues to grow, he said, exchange rates should continue to fall.

However, the amount that individual consumers pay also depends on the subsidies and tax credits to which they are entitled. With the economy as it is, he said, some people may qualify for larger subsidies.

The U.S. Bailout, a pandemic relief program, has expanded the tax credits available to people who buy plans on the stock exchange. Additional grants are due to expire at the end of 2022, but Congress plans to extend them. Rowe said it looks like it could happen.

Medicaid eligibility has also expanded during the pandemic. This will end when the federal government ends the public health emergency. Rowe said blue cross predicts that some of those who will lose their Medicaid coverage will enter the market.

“It’s been a long time coming,” he said of the insurer’s return to the market, “and we’re excited about it.”

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