Obamacare update: $0 premium plans and another hospital joins network

Dec. 12--Shawnee Mission Health is now covered by one of the Affordable Care Act insurers selling plans in the Kansas City area, and another insurer is offering plans with no premiums to some customers.

Shawnee Mission Health was among several major medical systems left with no coverage after Blue Cross and Blue Shield of Kansas City decided to get out of the ACA, commonly called Obamacare.

Ambetter, a new insurer to the Kansas City Obamacare market, has negotiated contracts with them one-by-one since then. Ambetter, a subsidiary of Missouri-based Centene, added the University of Kansas Health System to its network last month and added Olathe Health last week.

Shawnee Mission Health officially joined the Ambetter network Monday, with just four days left in the open enrollment period.

"We appreciate the community's patience as we've worked to ensure we remained in the exchange in 2018," said Alan Guyton, Shawnee Mission Health's vice president of finance. "This option allows our patients who are enrolled in health coverage through the exchange to continue their care with us, and provides another health care option for patients in the Kansas City area."

People who have already signed up for an Obamacare plan may switch during the open enrollment period.

Ambetter is selling plans in Johnson County and Wyandotte County in Kansas and in dozens of counties in northwest Missouri. Cigna is selling plans in five counties on the Missouri side of the Kansas City metro: Jackson, Clay, Platte, Cass and Ray.

Medica Health is selling plans throughout Kansas. It has signed a deal with St. Luke's Health System to make St. Luke's the exclusive hospital for its adult customers in Johnson and Wyandotte counties, but recently added Children's Mercy Hospital for pediatric care.

A Medica spokesman said via email that thousands of consumers in several states are eligible for $0 premiums if they purchase the company's bronze plan and qualify for enough federal subsidies based on their income.

That includes an estimated 1,200 consumers in Kansas.

"We recognize that 2018 is a very challenging year for people who purchase health insurance on their own and that premiums are very high," said Medica Vice President Geoff Bartsh.

"It is important to remember that many consumers will be able to obtain health coverage at significant price reductions through premium tax credits. This is the last week of the open enrollment period and we can't encourage people strongly enough to shop on healthcare.gov to learn what discounts may apply to them."

Blue KC's exit from the Obamacare marketplace left Kansas City consumers with narrower provider networks to choose from, and those networks remain in flux. A Children's Mercy executive said last week that the hospital is still in negotiations with Ambetter about joining its network, but the two sides are far apart on reimbursement rates.

Medica spokesman Greg Bury said Monday that the company is closing in on a contract to cover ophthalmology services.

Andy Marso: 816-234-4055, @andymarso

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