Obamacare impact: some NE Ga counties to lose Blue Cross coverage, others to gain

With open enrollment for Obamacare weeks away, Blue Cross customers across several Georgia counties have received letters from the insurance giant saying their health plan will no longer exist there next year.

Bob Roberts, a radio announcer in Vidalia, thought it was just a renewal letter, he said. “But it wasn’t.”

“I mean what am I going to do?” he asked. “We’re kind of out here in the cold.”

What no one told Roberts is that Georgia still expects every county to be covered by at least one insurance option under the Affordable Care Act, also known as Obamacare. The letter suggested the client call or go to the Obamacare website healthcare.gov to see his or her options; those are not yet posted. Pre-shopping plan information for 2019 coverage is expected to be posted on healthcare.gov shortly, and it will go live for real shopping Nov. 1.

The letters from Blue Cross apply to customers on the individual market, including the ACA exchange.

The last-minute news shook agents and customers in the individual market, raising the specter of uncertainty that has jostled the individual market over the past couple of years. At that time, as the Trump administration focused on its campaign promises to undo pieces of Obamacare with help from the GOP-led Congress, insurance companies said they had to raise prices and pull back coverage to compensate for the market uncertainty.

This year, in contrast, announcements for 2019 coverage had been largely sanguine. Rates are expected to stay stable, companies are expanding coverage and Blue Cross is returning to metro Atlanta. Although struggles continue over the ACA, including a lawsuit filed by states including Georgia, companies appear to have baked that uncertainty into their prices now.

The company told The Atlanta Journal-Constitution in a statement that it revised its 2019 Georgia coverage proposals after a thoughtful review. “This was a difficult decision,” Blue Cross told its clients in the letter, “because we’re committed to offering you and your family affordable health benefits.”

The move came after companies filed their initial plans and could see what their competitors offered. Health insurance companies make their first proposals to the Georgia Department of Insurance for rates and coverage in early or midsummer; then they negotiate with the state for a final proposal by August. Those proposals rarely change afterward, but they can and have.

Blue Cross now expects to serve only 75 of the state's 159 counties in 2019, fewer than it originally proposed. State officials point out that it will still serve more people than in 2018 because it's adding back populous counties that it had left.

“Overall, there’s slightly more competition,” especially from the Atlanta area northward, said Tom Carswell, the director of the product review division of the state Insurance Department. “There’s more coverage in more counties than there was last year.”

And, he added, all counties will have coverage. Companies such as Ambetter expanded into other counties, allowing Blue Cross to draw back without leaving a county dry.

The reason for the withdrawal likely comes down to money.

One of the major factors for insurance companies isn’t just how much money it can make from the customer base in a given county, but how good the contracts are that it’s able to strike with hospitals and doctors in a given geography.

In areas with fewer health care providers, the providers might have more bargaining power, and that can make the contracts less lucrative.

Blue Cross Blue Shield of Georgia expects to serve fewer counties than it originally proposed on the Obamacare market next year, but the company will reach more people. According to Blue Cross, these are the counties it will serve in 2019.

COUNTIES BLUE CROSS IS EXPANDING INTO IN 2019:

1. Bartow
2. Cherokee
3. Cobb
4. Coweta
5. DeKalb
6. Douglas
7. Fayette
8. Forsyth
9. Fulton
10. Gwinnett
11. Henry
12. Lamar
13. Pike
14. Fannin
15. Banks
16. Dawson
17. Franklin
18. Habersham
19. Hall
20. Hart
21. Lumpkin
22. Rabun
23. Stephens
24. Towns
25. Union
26. White
27. Chattooga
28. Floyd
29. Gilmer
30. Pickens
31. Polk

COUNTIES BLUE CROSS WILL CONTINUE SERVING IN 2019:

1. Morgan
2. Oglethorpe
3. Jasper
4. Carroll
5. Haralson
6. Heard
7. Burke
8. Columbia
9. Emanuel
10. Glascock
11. Jefferson
12. Jenkins
13. Lincoln
14. McDuffie
15. Richmond
16. Taliaferro
17. Warren
18. Wilkes
19. Charlton
20. Ware
21. Upson
22. Atkinson
23. Johnson
24. Laurens
25. Crawford
26. Berrien
27. Brooks
28. Clinch
29. Colquitt
30. Cook
31. Decatur
32. Early
33. Echols
34. Grady
35. Lanier
36. Lowndes
37. Seminole
38. Thomas
39. Tift
40. Turner
41. Baldwin
42. Hancock
43. Washington
44. Wilkinson

Source: Anthem Inc.