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14 Nevada counties could have no options on state health insurance exchange

KRNV - Health Insurance Shakeup Ben PKG
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Fourteen Nevada counties could be without qualified health plans on the state's individual insurance exchange next year, according to state officials, news that comes on the heels of one major provider's announced withdrawal.

According to a statement from the Silver State Health Insurance Exchange, Nevada insurance carriers that participate in the state-based exchange will only offer coverage to Washoe, Clark and Nye counties starting in 2018.

Prominence Health Plan executives say they've decided to exit the health plan exchange marketplace effective Jan. 1, 2018.

Anthem Blue Cross and Blue Shield will also reduce coverage to just Washoe, Clark and Nye counties, according to Heather Korbulic, executive director of the Silver State Health Insurance Exchange.

Korbulic said in an interview with News 4-Fox 11 that conversations are continuing about persuading providers to rejoin the exchange before a Sept. 20 deadline this year.

She called the issue "a healthcare crisis," however, saying in a statement that thousands of Nevadans could lose their access to affordable insurance.

"Regardless of the uncertainty surrounding the future of healthcare reform, the Exchange is focused on how to implement a successful Open Enrollment for Plan Year 2018," Korbulic said. "Given significant disruptions to the individual market in both the long and short term, my staff and I are doing everything within our control and influence to secure resources for consumers in these 14 counties."

The state's commissioner of the Division of Insurance, Barbara Richardson, said residents in the 14 affected counties would not have access next year to subsidies or cost-sharing assistance that come with the Affordable Care Act.

"We strongly encourage our Exchange carriers to expand proposed QHP service areas to ensure that all Nevadans will continue to have access to Exchange plans," Richardson said in a statement.

In an email sent to all exchange insurance agents and brokers, Prominence said the decision will impact members in Nevada counties.

Customers affected are those who purchase insurance through the individual marketplace. All current 2017 plans will continue to be offered through the remainder of the calendar year for 2017 coverage only, according to Prominence.

Existing plan members will maintain their current coverage without interruption for the remainder of the calendar year.

Prominence Health Plan said it will continue to offer approved plans in the Nevada market for Small Group (2-50), Large Group (50+), and Medicare Advantage in participating counties.

The plan will begin the withdraw process on Jul. 1, 2017, and complete the process on Dec. 31, 2017.

An Anthem spokesperson said in a statement the state's individual insurance market "remains volatile," and that planning and pricing are "increasingly difficult due to a shrinking and deteriorating" market:

However, the Nevada individual market remains volatile, making planning and pricing for ACA-compliant health plans increasingly difficult due to a shrinking and deteriorating individual market, as well as continual changes and uncertainty in federal operations, rules and guidance, including cost sharing reduction subsidies and the restoration of taxes on fully insured coverage.

Gov. Brian Sandoval said in a statement he has "communicated the news of this crisis to" the U.S. secretary of Health and Human Services:

My administration is working diligently to identify solutions to ensure that there is, at the very least, a safety net available to rural Nevada residents who will be left without any options for coverage in the wake of these devastating and unfortunate decisions. I have communicated the news of this crisis to U.S. Health and Human Services Secretary Tom Price and the state will pursue all available options to help the individuals and families who will be hurt by this decision. The reduced footprint of carriers on the Exchange will leave more than 8,000 Nevadans with no coverage, and that is unacceptable. The expansion of Medicaid and subsidized Qualified Health Plans in Nevada has helped to dramatically reduce uninsured rates for these individuals. Lack of coverage in rural Nevada will set back the years of work we have done to reduce the uninsured rate throughout our state. My office has been engaged with the carriers, the Exchange and the DOI and I am hopeful that we will find a solution that will benefit consumers in our state’s bare counties.

Members of the state's congressional delegation have also responded to the news with their own statements.

Republican Rep. Mark Amodei called Anthem's withdrawals from several counties "another symptom of the sickness that is killing America's health care system," and that "it's clear the status quo isn't working."

Democratic Sen. Catherine Cortez Masto said the cause is "Republicans and President [Donald] Trump threatening to repeal the Affordable Care Act and toying with people’s healthcare."

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