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home : local news : local news August 17, 2017

6/11/2017 12:59:00 PM
Insurance-less: Anthem pullout could leave hundreds of local residents without health insurance
Hundreds of Jackson County and Vinton County residents are in line to lose their current health insurance coverage at the end of this year due to this week's decision by Anthem to pull out of the exchange in Ohio for the Affordable Care Act (ACA), also known as Obamacare.

Jackson and Vinton are among the 18 counties where Anthem was the only health insurance provider participating in the ACA exchange. There are 10,500 current Anthem customers in the 18 counties who are currently not expected to have an Obamacare plan available as a result of Anthem's planned exit, which was announced Tuesday, June 6, a day after the deadline for companies to file proposed rates in Ohio for next year.

A spokesman for the Ohio Department of Insurance (ODI) told The Telegram the situation affects approximately 500 residents in Jackson County and 200 in Vinton County who receive health insurance through ACA. These numbers do not include those who purchase health insurance privately as individuals. Thus, the potential impact is huge in the local two-county area.

An important sidebar is that Anthem's decision does not affect group health insurance coverage it and other companies provide through employers.

"If you received health insurance through your employer, you are unaffected," Peoples Insurance Group Benefits Executive Patrick H. Ball said from his Jackson office. "But if you receive health insurance through HealthCare.Gov (the ACA registry website), or privately on your own, you won't be able to get health insurance as of January 1st, 2018 -- unless something changes. You won't be able to buy health insurance with any amount of money."

Also, Ball points out some older policies (purchased prior to the passage of the ACA) known as "grandfathered" plans will remain in force. Individuals who have questions about whether or not their policies are "grandfathered" should call their broker.

Obamacare has had both its proponents and critics since many of its provisions took effect in 2014. Opponents feel it hasn't worked well and that its provisions have chased health-insurance providers from the market. It's a fact that in Ohio participating companies dropped from 17 to 11 in 2016 alone. On the other hand, blame has been cast on Republican President Donald Trump and the GOP-controlled Congress for its recent actions to repeal and replace Obamacare, which has consequently resulted in "uncertainty" and "volatility" in the market.

Anthem issued the following statement in conjunction with its decision: "The individual market remains volatile and the lack of certainty of funding for cost-sharing reduction subsidies, the restoration of taxes on fully insured coverage and, an increasing lack of overall predictability simply does not provide a sustainable path forward to provide affordable plan choices for consumers."

ODI also issued the following statement: "For the past few years we have seen a weakening in the federal insurance marketplace as a number of companies have withdrawn from the exchange," said Chris Brock, the assistant director of public affairs ODI.

"We have always argued the private insurance market is the most severely impacted by the federal law and that is where Congressional action is needed to restore stability," Brock continued. "The Department of Insurance is looking for options to help the approximately 10,500 Ohioans in counties where there may not be an exchange plan when this takes effect in 2018. Today, planning and pricing for ACA-compliant health plans has become increasingly difficult due to the shrinking individual market as well as continual changes in federal operations, rules and guidance."

Holzer Medical Center

Predictably, responses from federal and state legislators and interest groups ran clearly along partisan lines, underscoring the deep political divide on the health-insurance issue and the government's role in it.

Republican Sixth District Congressman Bill Johnson - "This isn't just an Appalachian problem, or an Ohio problem; this trend is nationwide. This is why Congress must act. The House recently passed the American Health Care Act, to expand choice in the market, lower costs, lower premiums, reduce taxes and the deficit, and return more healthcare decisions to patients and doctors -- not bureaucrats."

Democrat U.S. Senator Sherrod Brown - "Anthem insurance cited uncertainty caused by plans to repeal the Affordable Care Act and President Trump's repeated threats to stop Cost Sharing Reduction (CSR) Payments that reduce out-of-pocket costs for Ohioans buying insurance in the individual market as the reasons for their decision to exit the exchanges in Ohio. By refusing to include a measure guaranteeing the continued payment of the Affordable Care Act's (ACA) cost-sharing reductions (CSRs) in the new fiscal year 2017 spending bill, the Administration and congressional Republican leaders have endangered health coverage for millions of Americans. They will bear responsibility for the premium increases, marketplace disruption, and coverage losses that will likely result." In his statement, Brown urged ACA opponents to "stop playing games" with people's healthcare.

Republican U.S. Senator Rob Portman - "For the past few years we've seen premiums and deductibles skyrocket because of the Obamacare law, as we've seen a declining number of viable health care choices for families and small businesses. Without true competition and choice in the market, we will never be able to lower health care costs for families and small businesses. This is one more reason why the status quo on health care is unsustainable. The Affordable Care Act has failed to meet the promises that were made to Ohio families. We can and must do better than Obamacare, but we should do it in a way that protects the most vulnerable in our society."

Republican U.S. Congressman Steve Stivers - "Yet again, we are seeing an insurance company exit the Ohio marketplace, leaving thousands in my district - including four entire counties - without an insurer on the individual market. This announcement is another reminder that the status quo of Obamacare is hurting Americans."

Ohio Senate President Larry Obhof - "Obamacare's rules and overregulation are placing a heavy burden on the people of our state. That is why I sponsored a provision in state law requiring the Ohio Department of Insurance to request a waiver of these onerous federal rules. It is my hope that the Trump Administration grants that waiver once it is filed."

Ball, who has been involved in the health-insurance business locally for quite a few years, was willing to speak out as well about the situation and admits he finds it both frustrating and regrettable.

"I agree with Mr. Brown's headline, 'Stop playing games with people's healthcare', but his anger seems to be directed at the wrong folks," Ball commented. "His anger should be squarely directed at both parties (including himself) for allowing things to go this far.

"If you doubt that the Democrats have any responsibility, consider this. Why did 20 counties in Ohio only have one insurance carrier in 2017? The Affordable Care Act eliminated all of the other health insurance carriers in those 20 counties. That is not the Republicans' fault."

However, Ball also believes the actions of both parties and their failure to work together and compromise also is a major factor.

"Apparently, they don't care about fixing the problem," Ball concluded. "Their concerns are purely political at this point. Both parties want to make sure that the other party receives the blame."

In spite of his feelings, he remains hopeful that "something will happen" to change things before January 1.

Reader Comments

Posted: Monday, June 12, 2017
Article comment by: SMSgt Carl Corvin

" Not the republicaNOs fault"-- please!!! From January 21, 2017 we have a pro-Russian republicaNO president- a republicaNO ( Formerly) U.S. House of Representatives, A republicaNO dominated (formerly) U.S. Senate at the national level. In Ohio we have a republicaNO gov. ( when he is in the state), a republicaNO lt. Gov. and a republicNO dominated state house and senate and you say it is NOT the republicans fault? the republicaNOs fought and had so many votes to destroy the Affordable Care Act that I stopped counting at 50 votes! Once again- we need a fair and bi-partisan committee to draw up the electoral districts-- it is quite obvious that the present system is corrupt to say the least. 'Nuff Said!

Posted: Sunday, June 11, 2017
Article comment by: mike alexander

It's time the goverment stepa in and tells these insurance companies they aren't running our country. They give everyone the same chances for insurance or make them shut them down completely.

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