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
See more stories about...
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 »
FOLLOWED CLOSED DOOR MEETING
Peña Nieto, Trump Trade Subtle Jabs in Statements
7 hours ago
THE DETAILS

Following their meeting, President Enrique Peña Nieto of Mexico and Republican nominee for president, Donald Trump, briefly addressed the media, with Peña Nieto subtly rebuking Trump's rhetoric. While he spoke respectfully about Trump, Peña Nieto did not back down, saying that free trade has proved effective and that illegal immigration into America from the south has decreased over the last ten years while the flow of people and drugs into Mexico has increased. Additionally, he stressed that Mexicans in America are "honest" and "deserve respect." Trump responded, calling some Mexicans "tremendous people" while saying others are "beyond reproach." Trump laid out five important issues, including the end of illegal immigration and the ability for either country to build a wall or border. However, Trump said he did not discuss who would pay for the wall.

LOWER COURT RULING STANDS
SCOTUS Won’t Restore NC Voter ID Law
8 hours ago
THE LATEST

A divided Supreme Court "refused Wednesday to reinstate North Carolina’s voter identification requirement and keep just 10 days of early in-person voting. The court rejected a request by Gov. Pat McCrory and other state officials to delay a lower court ruling that found the state law was tainted by racial discrimination."

Source:
SMOKIN’ AND SHOOTIN’
Court: 2nd Amendment Doesn’t Protect Pot Users’ Gun Rights
8 hours ago
THE DETAILS
CHICAGO DISTRICT
Woman Self-Immolates in Congressman’s Office
10 hours ago
THE DETAILS

"Police say a woman walked into U.S. Rep. Danny Davis' office on Chicago's West Side, drank out of a bottle of hand sanitizer, poured the sanitizer over herself and set herself on fire with a lighter." The Democrat wasn't in the office at the time.

Source:
THE QUESTION
How Many Offices Does Trump Have in Battleground States?
13 hours ago
THE ANSWER

Eighty-eight, according to PBS. Hillary Clinton, meanwhile, has 291 offices in those same 15 states.

Source:
×