NWI residents will have fewer Obamacare options in 2017

Aug. 26--Northwest Indiana residents will have fewer choices on the Obamacare insurance marketplace in 2017. And the plans they do have to choose from will be more expensive.

The Indiana Department of Insurance this week submitted marketplace rate increases to the U.S. Department of Health and Human Services for final approval. They ranged from a 5.3 percent decrease to a 29 percent increase for the six insurers that plan to sell individual 2017 plans on and off the exchange. Not all those companies will offer plans in the Region.

"What is worrisome is the selections are getting so thin," said Jeff Sopko, a Steger insurance broker. "It's not only the premium increases, but what medical care you can access is getting smaller and smaller."

As states file rate increases with the feds, Obamacare marketplace premiums look to be going up significantly next year. This is a result of the larger-than-expected number of sick people signing up for plans and a course correction for insurers who initially offered low rates.

Low-income Americans who receive subsidies to buy insurance won't feel the sticker shock; those who earn too much for the tax credits will.

Insurers also are increasingly dropping out of the exchanges, while many of those that remain are narrowing their provider networks.

"The bigger issue is the fact this geographic area has limited carrier involvement," said Will Glaros, a Schererville employee benefits specialist.

UnitedHealthcare, the nation's largest insurer, pulled out of the marketplace in Indiana and most other states because of increasing financial losses from Obamacare. The company made $1.9 billion in profits in the second quarter of 2016, but it expects to lose $800 million from exchange plans this year. UnitedHealthcare had offered the only wide-network PPO plan on the individual market in Northwest Indiana.

Aetna had filed to enter the exchange for next year but ended up withdrawing its request; the insurance company also has left most other state marketplaces due to concerns about its profits, it said. However, the Huffington Post recently unearthed a letter Aetna's CEO wrote to the Department of Justice threatening to exit the exchanges if the department blocked its proposed merger with Humana.

For 2017, Northwest Indiana residents shopping on the individual marketplace likely will be limited to Anthem, MDWise and Ambetter and only be able to purchase managed-care HMO plans. The state approved a 29 percent increase for Anthem, an 11.5 percent increase for MDWise and a 5.3 percent decrease for Celtic (Ambetter's parent company).

"Anthem's 2017 rates are intended to cover anticipated claims costs driven by the increased use of medical services and higher drug costs," said Tony Felts, a spokesman for Anthem.

Sopko said the latest developments are evidence that the marketplace, as designed, "isn't working out very well." And fixing it likely will require a political solution, one that won't come until after the next president is inaugurated at the earliest.

"It seems like the individual marketplace is failing," he said. "If the companies were making money, they'd all be in it."

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