The only two insurance companies offering individual health plans on federal exchanges in Arizona have filed paperwork to continue selling coverage in 2018, raising hopes that the state can avoid a repeat of last year's crisis when one county was briefly left without a health insurance provider.
Officials with Blue Cross Blue Shield Arizona and Centene Corp's Ambetter by Health Net confirmed this week that they have filed with the state Department of Insurance to continue offering insurance.
The companies have until July 1 to notify current customers if they change their plans and decide to pull out of the market. But if they follow through, the situation that developed last August when Aetna pulled out of Pinal County, leaving it without a plan for 2017, will be avoided. Blue Cross stepped in and offered coverage in Pinal County, sparing an estimated 8,000 to 10,000 customers from being left without individual insurance.
Blue Cross sells in 13 mainly rural counties and will maintain a similar set of plans next year as it currently offers. Health Net filed to again sell plans in Pima and Maricopa County.
Whether the two remaining Arizona providers would stick it out has been an open question, closely watched by health care insiders. Tara Plese, a spokeswoman for Arizona Alliance for Community Health Centers, said her group spoke regularly with the insurers and believed they would stay. "We had some assurances that they would do so," Plese said Tuesday.
Losing either of the companies would have been catastrophic for the insurance exchanges created under the Affordable Care Act. Iowa is scrambling to come up with a way to keep the only remaining provider selling in that state after three other insurers decided they would leave that market. Several counties in Missouri, Ohio and Washington state have no insurer for next year.
Pricing information hasn't been released by the companies or the Department of Insurance, which will release proposed increases above 10 percent next month and all pricing by early-October. This year, the average premium in Arizona before subsidies nearly doubled, from $324 a month last year to $611 a month.
Those price boosts had varying effects, mainly because many people were shielded from them because of tax subsidies that increase with rates. But the number of people who signed up for insurance this year in Arizona who don't qualify for subsidies that can cover much of the cost of insurance plunged by 23 percent, according to an analysis of federal data released in March done by the University of Arizona health insurance expert Dr. Daniel Derksen. Meanwhile, signups by people who get subsidies went up by 3 percent.
The total number of Arizonans who received subsidies went up from 75 percent last year to 86 percent this year, according to data released by the federal Centers for Medicare and Medicaid Services on Monday.
The fate of those subsidies and of cost-sharing payments to insurers to help offset costs for lower-income customers is in doubt because of an effort to replace the Obama-era law with a new Republican-backed health plan. A proposal that passed the House is now being reworked in the Senate.
The agency said in a news release that affordability was affecting enrollment, pointing to the number of consumers who chose insurance plans during the most recent open enrollment period and then didn't pay the premiums. About 16 percent of the people who chose plans nationally didn't "effectuate" that coverage by paying the needed premiums.
In Arizona, the number was much higher. At the close of open enrollment, 196,000 people had chosen a plan in Arizona. But numbers released by the government show only about 140,000 paid the premium, a drop-off of 28 percent. State enrollment topped out at about 171,000 early last year.