Here's one for Paul that just came out in my local news paper today:
"HARRISONBURG — For thousands of people in the central Valley, the options for health insurance in 2018 might be few or none.
Anthem announced in August that it would leave Virginia’s Affordable Care Act Marketplace in 2018. The decision came on the heels of Aetna’s declaration in May that it, too, would pull out of Virginia.
The decisions could make Optima Health the only health insurance option in most of the state.
However, because Optima will only stay in the market in areas with Sentara Healthcare hospitals, about a third of Virginia and nearly all of the central Valley will have no options, according to Steve Flora, a health insurance consultant for a Blue Ridge Insurance Services. Optima is the insurance arm of Sentara.
Sentara RMH Medical Center means coverage for people in Harrisonburg and Rockingham County.
But no Sentara hospitals means no Optima in the
individual marketplace for people in Augusta, Page and Shenandoah counties or Staunton and Waynesboro. Anthem and Aetna covered Augusta and Shenandoah counties in 2017.
Recipients also are facing the prospects of being uninsured and getting penalized for it through the individual mandate in the ACA, commonly called Obamacare.
Karin Flagle, president of Blue Ridge Insurance Services, summed up several people’s thoughts.
“We are not happy,” she said. “It’s going to affect quite a bit of people in this area.”
Thousands Covered
Anthem and Aetna have called the marketplace unstable. President Donald Trump made repealing former President Barack Obama’s health care law a priority after taking office.
But lawmakers can’t agree on a replacement or method to fix the existing law, and the enrollment period for 2018, which runs Nov. 1 to Jan. 31, quickly approaches.
About 14,000 people are covered this year through the Affordable Care Act in Rockingham, Shenandoah, Page and Augusta counties and Harrisonburg, Staunton and Waynesboro, according to the U.S. Department of Health and Human Services.
Rockingham County has the highest number in the area with 3,925 people covered, followed by Augusta with 3,648. In Harrisonburg, 1,805 people are covered.
LD&B Insurance and Financial Services carries about 800 policies under the Affordable Care Act, many of which likely cover several members of the same family. Blue Ridge Insurance Services has roughly 400 to 500 plans. More than half of LD&B policies and most of Blue Ridge’s plans are through Anthem.
Few Options
Anthem and Aetna will offer coverage to employers. Anthem will offer Medicare supplements in 2018.
However, the self-employed or those who aren’t offered insurance through work will be left with few options.
Things could change for people in areas with Optima coverage as well. The company plans to increase its rates for individuals by about 82 percent to stay in the market, according to a press release. For Affordable Care Act customers who receive subsidies, the government will pick up most of the hike, leaving them with an average increase of 1.5 percent, or about $4 per month, the release says.
People covered by Optima through their employer likely won’t be affected by the cost increase.
Jonathan Coddington, employee benefits division manager for LD&B Insurance and Financial Services, said the bigger issue is a lack of coverage in some areas as opposed to the price hike.
“At least it’s available,” he said of the increase. “We’ve got more concern for folks that don’t have options.”
Eric Swartley, an LD&B employee benefits representative, said the company is “tasked with figuring out” how to serve people in areas without Optima. Coddington said the solution could be unfamiliar.
“At this point there are no fully insured options that folks are used to,” he said.
The implications have yet to resonate, Flora said.
“At this point, it doesn’t seem to hit the collective consciousness of everyone in the area,” he said. “But when it does, I think there’s going to be quite a bit of panic in these counties.”
‘Wait And See’
Most of the local Obamacare recipients Blue Ridge serves receive a federal subsidy, which could be in jeopardy. The subsidy is based on income and reduces premiums.
They are available only for households within 100 percent to 400 percent of federal poverty level. Below 100 percent, applicants may qualify for Medicaid; above 400 percent, people pay full price.
In 2017, the poverty level was about $24,000 for a family of four and $12,000 for one person. Four-hundred percent of the level is about $96,000 for a family of four and $48,000 for one person.
Coddington isn’t sure how many of LD&B’s policies receive a subsidy.
In the central Valley, at least 59 percent of customers receive a subsidy.
Trump has threatened to withhold the subsidies to cause the health law to fail.
However, when Congress convenes in the fall, it could continue the monthly payments of cost-sharing reduction subsidies to insurance providers.
“It’s a wait and see at this point,” Flora said."
