Blue Cross Georgia pullback: questions and answers


Thousands of Georgians will have to find a new health insurance company next year when Blue Cross Blue Shield of Georgia pulls out of the individual market for 74 counties, including those in metro Atlanta. It will be the first time in decades that Blue Cross has not served the individual market in the Atlanta area. The news has roiled the health insurance market and has customers and agents asking questions.

Here The Atlanta Journal-Constitution answers some of them:

WHO

Q: Does this affect every policy in those 74 counties?

A: No. It affects individual policies, not group or employer policies or Medicare supplemental policies. Blue Cross still intends to offer group coverage in all 159 counties in the state.

Q: Does this affect individual policies if they’re on the traditional market, non-Obamacare policies?

A: Yes. In those 74 counties, Blue Cross intends to stop offering individual policies, whether they were bought through the Affordable Care Act exchange or not.

WHEN

Q: Do I lose my policy right away?

A: No. The changes take effect in 2018. Members can use their Blue Cross plans until Dec. 31. BUT open enrollment will start in the fall, so it’s a good idea to start thinking about your alternatives now.

WHY

Q: Why?

A: According to Blue Cross, it’s simple: uncertainty, sparked by the White House and House Republicans with regard to a type of insurance subsidy. An important part of Blue Cross’ business depends in part on subsidies called Cost-Sharing Reductions that are paid by the federal government to offset the cost of insuring lower-income Obamacare exchange customers. President Donald Trump has threatened those payments, calling them “BAILOUTS,” and House Republicans have filed a lawsuit over how they’re paid.

BUT?

Q: I thought I read that Blue Cross was staying in the whole state.

A: Blue Cross filed initial plans to stay in the whole state with individual policies. But that was preliminary. And it gave a hint of what was to come by noting concerns with the uncertainty.

Q: So will all the same Obamacare policies be offered in the counties where Blue Cross is remaining?

A: On the ACA exchange, Blue Cross only confirmed that it will offer “silver” plans in correspondence with the state.

Q: So is this the final decision for 2018?

A: No. Blue Cross could still make major changes by Sept. 27. Those 40 percent rate increases they suggested this summer? Those could go up even further “if the federal government has not provided any more certainty by then” or if Georgia’s market changes. But the good news is, it expressed a desire to see more certainty in the market and come back into the counties it’s leaving.

This is the list of 85 counties that Blue Cross Blue Shield of Georgia provided where it intends to continue serving individual policies in 2018:

Appling

Atkinson

Bacon

Baldwin

Ben Hill

Berrien

Bibb

Bleckley

Brantley

Brooks

Bryan

Bulloch

Burke

Camden

Candler

Carroll

Charlton

Clinch

Coffee

Colquitt

Columbia

Cook

Crawford

Decatur

Dodge

Dooly

Early

Echols

Effingham

Emanuel

Evans

Glascock

Glynn

Grady

Hancock

Haralson

Heard

Houston

Irwin

Jasper

Jeff Davis

Jefferson

Jenkins

Johnson

Jones

Lanier

Laurens

Liberty

Lincoln

Long

Lowndes

McDuffie

McIntosh

Meriwether

Miller

Monroe

Montgomery

Morgan

Oglethorpe

Peach

Pierce

Pulaski

Putnam

Richmond

Screven

Seminole

Taliaferro

Tattnall

Telfair

Thomas

Tift

Toombs

Treutlen

Troup

Turner

Twiggs

Upson

Ware

Warren

Washington

Wayne

Wheeler

Wilcox

Wilkes

Wilkinson

Sources: Blue Cross Blue Shield of Georgia and Georgia Department of Insurance


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