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Obamacare insurers abandon two counties in Washington state, insurance commissioner blames Trump administration

  • In Ohio, 18 counties may end up having no Obamacare insurer next year.
  • In Missouri, 25 counties are on track to have no Obamacare insurer.
  • Uncertainty over cost-sharing reduction payments to insurers has led some insurers to request higher prices, or consider departing the individual plan market.
President Donald Trump (C) gathers with Vice President Mike Pence (R) and Congressional Republicans in the Rose Garden of the White House after the House of Representatives approved the American Healthcare Act, to repeal major parts of Obamacare and replace it with the Republican healthcare plan, in Washington, U.S., May 4, 2017.
Carlos Barria | Reuters
President Donald Trump (C) gathers with Vice President Mike Pence (R) and Congressional Republicans in the Rose Garden of the White House after the House of Representatives approved the American Healthcare Act, to repeal major parts of Obamacare and replace it with the Republican healthcare plan, in Washington, U.S., May 4, 2017.

The insurance commissioner of Washington state blamed the Trump administration Thursday for the planned departure of two insurers from the state, where two counties will be left without options for Obamacare plans next year.

Washington residents next year also will have less than half the number of individual health plans that they can now buy both on and outside of the state's Obamacare insurance exchange.

Insurance Commissioner Mike Kreidler said the Trump administration and the Republican-led Congress have eroded confidence in the nation's insurance markets by pushing for a repeal of Obamacare and refusing to guarantee billions of dollars in reimbursements expected by health plans.

Kriedler's criticisms echo those of other Obamacare defenders, who say President Donald Trump is sabotaging the individual insurance markets, leading to the exit of some insurers and big rate hike proposals by others, even while Trump claims Obamacare is a failure that customers need relief from.

"For months, we've worked closely with our health insurers and other stakeholders in a concerted effort to try to explain to the Trump administration and congressional leaders what the impact could be to our market and most importantly, to our consumers, if this level of uncertainty and volatility continued," Kreidler said.

"Today, our predictions came true."

Washington will have 11 insurers offering just 71 health plans throughout the state next year. That's down from 13 insurers selling 154 plans this year, Kriedler's office said.

There will be just six insurers on the state's Obamacare exchange — down from the current level of nine, and just 39 plans will be available, the office said.

But no insurer filed proposals to sell individual plans either on or outside the exchange next year in either Klickitat or Grays Harbor counties.

As of March, those counties had more than 3,330 residents combined covered by individual plans, the kind of private health coverage available to people who do not have insurance through a job.

The state' Obamacare exchange, Washington Health Benefit, said there are more than 2,100 people in those counties who buy a plan on that marketplace.

In Grays Harbor, customers received an average of $408 per month in federal tax credits to reduce the cost of their insurance premiums, the third highest such average in the state. The value of those credits is tied to both the cost of the plans and customers' incomes — the more the insurance costs and the less a customer makes, the more they get in subsidies.

There are 37 other counties in Washington, which statewide has about 316,000 people who buy individual insurance plans.

Under Washington law, if no health insurer is available to sell Obamacare plans in a county, customers of such plans can get coverage through the state's high-risk pool, known as WSHIP. But because WSHIP is not a qualified insurer for the state Obamacare exchange, people covered through it would not qualify for federal subsidies that reduce their health-care costs.

Kreidler said he will be contacting insurers this week "to strongly encourage them to reconsider their participation in the two counties that have no options for 2018." The commissioner said proposed insurance rates for 2018 will be released June 17.

Washington is just the latest state to be confronted with the possibility of having no Obamacare insurers selling plans in a number of counties next year.

Earlier this week, big insurer Anthem said it would effectively abandon its Obamacare plan business in Ohio next year, leaving 18 counties in that state potentially with no insurer.

Another 25 counties in Missouri also could be without an Obamacare insurer next year because of the planned departure of Blue Cross and Blue Shield of Kansas City.

Other insurers are proposing sharply higher premium rates next year, often in large part due to uncertainty over whether the Trump administration will continuing paying insurers cost-sharing reduction reimbursements. Those CSRs compensate insurers for subsidies available, by law, to low-income Obamacare customers to reduce the amount of money they pay out of pocket for health-care services.

"I'm deeply troubled by the changes we're seeing for next year's health insurance market," said Kreidler.

"The proposed drop in insurers and coverage areas clearly indicates to me that the uncertainty the Trump administration and the GOP-controlled Congress has sowed for months is sabotaging the progress we've made," Kreidler said.

"Their actions, including failing to commit to fund the cost-sharing subsidies, not enforcing the individual mandate, and continuing to push in secret the severely flawed American Health Care Act are eroding confidence health insurers have in the market here and across the nation," he said. "These actions only increase premiums and decrease insurer participation."

Alleigh Marre , a spokeswoman for U.S. Department of Health and Human Services, in response said, "This news is not surprising nor is it unique to Washington state."

"Obamacare has delivered higher prices and fewer choices for years. Last year alone 83 insurers left the Obamacare marketplace leaving millions of Americans paying more and getting less," Marre said. "Now is the time to advance real health-care reform that empowers individuals and families with the choices and resources they need to buy a plan that meets their health-care needs without breaking their budgets."

Pam MacEwan, CEO of the Washington Health Benefit Exchange, said, "Despite the strength and stability of our state's marketplace efforts, we were disappointed with the health insurance filing proposals submitted with the Office of the Insurance Commissioner for participation on the 2018 exchange."

She said that although a number of insurers will return next year, "we also were dismayed by the role federal uncertainty played into the decision of others to discontinue offering products or scale back their existing service areas. This federal uncertainty is tied to whether the administration will continue to fund cost-sharing reductions or enforce the individual mandate."

"What makes today's announcement particularly difficult is that the market forces at work are occurring outside of the exchange's purview and disrupting what was viewed as a stabilizing health insurance marketplace," MacEwan said.