Obamacare Insurance Choices Shrink for Individual Buyers in New Hampshire

MANCHESTER, NH - AUGUST 20: People watch as Republican presidential candidate, former Massachusetts Gov. Mitt Romney speaks during a campaign stop at Saint Anselm College on August 20, 2012 in Manchester, New Hampshire. Romney and and his vice presidential candidate U.S. Rep. Paul Ryan (R-WI), held the town hall-style event just two days after President Barack Obama made campaign stops in New Hampshire. (Photo by John Moore/Getty Images)
National Journal
Clara Ritger
Oct. 31, 2013, 4:06 p.m.

In the new health in­sur­ance mar­ket­places cre­ated by the Af­ford­able Care Act, 95 per­cent of Amer­ic­ans will have at least two in­sur­ance com­pan­ies from which to com­pare and se­lect plans, ac­cord­ing to a Health and Hu­man Ser­vices De­part­ment ana­lys­is.

But that also means 5 per­cent of Amer­ic­ans — in­clud­ing all res­id­ents of New Hamp­shire and West Vir­gin­ia — will not have a choice.

An­them Blue Cross and Blue Shield is the only in­sur­ance com­pany par­ti­cip­at­ing in New Hamp­shire’s ex­change. “The leg­acy of our com­pany has been to par­ti­cip­ate ag­gress­ively in the state,” said An­them spokes­man Chris Dugan.

An­them cov­ers ap­prox­im­ately 80 per­cent of res­id­ents pur­chas­ing plans on the state’s ex­ist­ing in­di­vidu­al mar­ket, said Tyler Brannen, a health policy ana­lyst at the New Hamp­shire In­sur­ance De­part­ment. Be­cause of New Hamp­shire’s small pop­u­la­tion, the fin­an­cial re­turns of an­oth­er in­sur­ance com­pany of­fer­ing com­pet­ing policies in the state would not be as great as in an urb­an mar­ket.

“Any oth­er car­ri­er would have to weigh the risk,” Brannen said.

An­them is of­fer­ing 11 plans on the ex­change, with monthly premi­um con­tri­bu­tions ran­ging from $177 to $1,784 be­fore tax sub­sidies. One big change An­them is mak­ing to its cov­er­age is the num­ber of doc­tors and hos­pit­als in­cluded in its in­sur­ance net­work.

“By part­ner­ing with cer­tain pro­viders, we are provid­ing a product that is 25 per­cent lower than it would be by us­ing a broad­er net­work,” Dugan said.

There is a down­side, though. The shift elim­in­ates 10 of the 26 ma­jor hos­pit­als in New Hamp­shire from the An­them net­work for people who cur­rently pur­chase An­them in­sur­ance on the in­di­vidu­al mar­ket and will shift to An­them’s ACA ex­change mar­ket next year, Brannen said.

Dugan was not sure if An­them would con­tin­ue to of­fer plans in the in­di­vidu­al mar­ket, in ad­di­tion to its ex­change mar­ket op­tions. Re­gard­less of what An­them does, Brannen said, he ex­pects the in­di­vidu­al mar­ket will phase out.

“To the ex­tent that people may qual­i­fy for a sub­sidy,” Brannen said, “I can’t think of any reas­on to pur­chase products from An­them out­side of the ex­change.”

Con­sumers are frus­trated and see the changes as a loss, Brannen said, es­pe­cially be­cause they don’t have an al­tern­at­ive to An­them.

But the use of nar­row net­works to drive down the cost of health in­sur­ance isn’t just a func­tion of the An­them mono­poly — it’s a na­tion­wide trend. A re­cent study from the Health Re­search In­sti­tute at Price­wa­ter­house­Coopers found that 69 per­cent of in­surers re­por­ted nar­row-net­work con­tracts.

Next year, some people could have to drive as far as 45 minutes to see an in-net­work doc­tor, Brannen said. But that doesn’t vi­ol­ate the state’s ad­equacy stand­ards that reg­u­late pro­vider dis­tance in in­sur­ance plans, he ad­ded.

Rais­ing those stand­ards could be the next task for poli­cy­makers, he sug­ges­ted, as voters enter the ex­change and come to terms with the real­it­ies of their new cov­er­age.

What We're Following See More »
BACKING OUT ON BERNIE
Trump Won’t Debate Sanders After All
2 days ago
THE LATEST

Trump, in a statement: “Based on the fact that the Democratic nominating process is totally rigged and Crooked Hillary Clinton and Deborah Wasserman Schultz will not allow Bernie Sanders to win, and now that I am the presumptive Republican nominee, it seems inappropriate that I would debate the second place finisher. ... I will wait to debate the first place finisher in the Democratic Party, probably Crooked Hillary Clinton, or whoever it may be.”

AKNOWLEDGING THE INEVITABLE
UAW: Time to Unite Behind Hillary
3 days ago
THE DETAILS

"It's about time for unity," said UAW President Dennis Williams. "We're endorsing Hillary Clinton. She's gotten 3 million more votes than Bernie, a million more votes than Donald Trump. She's our nominee." He called Sanders "a great friend of the UAW" while saying Trump "does not support the economic security of UAW families." Some 28 percent of UAW members indicated their support for Trump in an internal survey.

Source:
AP KEEPING COUNT
Trump Clinches Enough Delegates for the Nomination
3 days ago
THE LATEST

"Donald Trump on Thursday reached the number of delegates needed to clinch the Republican nomination for president, completing an unlikely rise that has upended the political landscape and sets the stage for a bitter fall campaign. Trump was put over the top in the Associated Press delegate count by a small number of the party's unbound delegates who told the AP they would support him at the convention."

Source:
TRUMP FLOATED IDEA ON JIMMY KIMMEL’S SHOW
Trump/Sanders Debate Before California Primary?
3 days ago
THE LATEST
CAMPAIGNS INJECTED NEW AD MONEY
California: It’s Not Over Yet
3 days ago
THE LATEST

"Clinton and Bernie Sanders "are now devoting additional money to television advertising. A day after Sanders announced a new ad buy of less than $2 million in the state, Clinton announced her own television campaign. Ads featuring actor Morgan Freeman as well as labor leader and civil rights activist Dolores Huerta will air beginning on Fridayin Fresno, Sacramento, and Los Angeles media markets. Some ads will also target Latino voters and Asian American voters. The total value of the buy is about six figures according to the Clinton campaign." Meanwhile, a new poll shows Sanders within the margin of error, trailing Clinton 44%-46%.

Source:
×