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Aetna exit means Pinal County has no marketplace health plan

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Posted at 2:21 PM, Aug 16, 2016
and last updated 2016-08-16 18:43:45-04

Pinal County won't have a company offering marketplace health insurance plans next year following the nation's third-largest health insurer's decision to exit public exchanges in all but four states.

Aetna was the only insurer planning to offer Affordable Care Act plans in Pinal County for 2017. It currently only sells in Maricopa County but had planned to expand to Pinal County.

Blue Cross Blue Shield of Arizona and UnitedHealthcare currently cover about 8,500 people in Pinal County. But United is pulling out of Arizona and Blue Cross is not offering plans there next year.

Arizona Insurance Department spokesman Stephen Briggs said Tuesday that Blue Cross filings would allow it to offer Pinal County plans.

Blue Cross said in a statement that "Arizona is now an example of what happens when the market is unstable, leaving residents with little choice.

"We are re-evaluating our 2017 plans and where Blue Cross Blue Shield of Arizona makes coverage available," the statement said. "Our leadership team is in the process of speaking with regulators in light of the recent news of Pinal County residents having no options."

Pinal County residents will have some off-marketplace options, but those don't qualify for federal subsidies many receive to help pay their premiums, Briggs said.

The announcement by Aetna late Monday adds to pressure on the exchanges that are a key part of President Barack Obama's health care overhaul law. Companies are citing losses on the exchanges because older, sicker-than-expected people are signing up for insurance, and not enough young and healthy people are buying coverage.

Health insurance companies that sell individual policies on the federal marketplace in Arizona are planning major premium increases for 2017, and Arizona is no exception.

In June, insurers filed notices with the Insurance Department seeking average increases of 8.7 percent to as much as 65 percent. Those numbers have since been revised upward, with insurers planning 19 percent to 122 percent premium boosts.

People who qualify for federal tax subsidies are shielded from the big increases. But higher-income people have to pay the entire amount.

As of December, about 155,000 Arizonans had coverage through the marketplace. The federal Centers for Medicare and Medicaid Services said 203,000 Arizonans had signed up for policies in 2017 but there's no way to determine how many of them have actually paid their premiums. The six insurers who filed for rate increases listed about 140,000 customers.

More than 12 million people nationwide get insurance from the marketplace. The coming year will be the fourth for the markets, and each year has seen dramatic shifts in Arizona's plans and premiums.