Medica hits health plan enrollment cap for 2017
State regulators approved caps as an emergency measure to limit losses and keep
Current enrollees still have the right to renew their coverage, but the loss of
That remaining health plan option, Mathson added, won't include all doctors.
"I believe this should be of great concern to those consumers," Mathson said.
The move applies only to the individual insurance market, where about 250,000 state residents buy coverage. It's the market for people who are self-employed or don't get health insurance from their employer. There is no impact on people with health insurance through employer-based plans or government programs like
The individual market is undergoing a fundamental transformation under the federal Affordable Care Act. Previously, health insurers were allowed to deny coverage to people with preexisting health conditions to lower costs.
The health law in 2014 started requiring insurers to offer all shoppers coverage. Since then, health plans have struggled to make the business profitable, prompting several carriers across the country to pull back from the market.
This has included a retreat from new government-run health exchanges like
The online marketplaces are an option for individual market consumers.
In September, the state
"Individual health plans from
Only Blue Plus -- the HMO from
Disruptions in the individual market for 2017 started this summer, when
Patients and lawmakers have complained that the Blue Plus network includes a fairly limited roster of doctors and hospitals, much like most health plans in next year's individual market.
Patients can still visit doctors and hospitals as out-of-network providers, but they would pay much more in out-of-pocket costs -- sums that could be prohibitively expensive.
In the
Mathson of the trade group for insurance agents said she didn't know how many people would have network problems due to the loss of
But she commented: "Many consumers will lose their doctors -- or pay high out-of-network coinsurance, with no cap on expenses."
Defenders say narrow network plans can better coordinate care for quality and efficiency.
Beyond the enrollment caps and network limits, all carriers in the individual market are boosting premiums by an average of at least 50 percent. In response, DFL Gov.
There's growing support for broader policy changes, as well, that might stabilize the market.
"Limiting the number of new people who can buy health insurance on their own from
Open enrollment in the individual market started
Blue Plus is available in all
Those shoppers won't be able to purchase plans through the MNsure website, but must phone the MNsure call center to enroll.
"The
Twitter: @chrissnowbeck
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