New Mexico insurer is dropping out of Obamacare exchange
posted at 7:21 pm on July 12, 2016 by John Sexton
The good news for Obamacare supporters is that a major insurer in New Mexico is no longer asking for a 30% rate hike next year. The bad news is that it’s because the insurer is dropping out of selling individual plans on the exchange altogether.
Presbyterian Health Plan, a major insurer in the New Mexico marketplace, has announced that it will be dropping out of the Obamacare exchange next year. The Albuquerque Journal reports:
The decision will affect 10,000 exchange members, 80 percent of whom now receive federal subsidies, said Brandon Fryar, president of the health plan, a for-profit subsidiary of Presbyterian Healthcare Services.
Presbyterian, which insures about 18 percent of the Obamacare market in New Mexico, has sent letters to members notifying them of the changes. Existing exchange policies will remain in force until the end of the year.
Presbyterian will continue to offer coverage through employers and small groups and will also sell individual plans apart from the exhcange. However, the Health Plan has decided that the Obamacare exchange is a significant money-loser:
Fryar said Presbyterian made the decision to stop offering exchange plans because patients who purchased there used medical services 30 percent more than other patient groups off the exchange. He did not provide a dollar figure.
Presbyterian Health Plan has been in discussions with state regulators for months before reaching this decision. Regulators say the remaining insurers will be able to take up the slack. But those insurers are mostly seeking big rate hikes for next year as well. For instance, Blue Cross is requesting rate increases, “between 20 percent and 83 percent higher.”
The fact that Presbyterian Health Plan is about to dump thousands of sicker-than-expected enrollees on the remaining insurers should add some urgency to those rate requests.