OKLAHOMA CITY – Blue Cross Blue Shield of Oklahoma has submitted a Qualified Health Plan application, along with rates, for certification in the federally-facilitated exchange for 2018. This is an initial indication that, for the second straight year, only one insurer in Oklahoma will offer exchange products in the individual market.
“There is an incredible amount of uncertainty in the market right now,” said Oklahoma Insurance Commissioner John D. Doak. “Insurers participating in Obamacare have experienced major losses. While we expect a full repeal of this disastrous experiment, insurers have to go by the regulations in place right now. That’s why we’ve seen so many insurers dropping out of exchanges across the country or resorting to double digit premium increases.”
The Oklahoma Insurance Department does not have statutory authority to approve or deny rate increases filed by insurers on the federal exchange. Oklahoma, along with Texas and Wyoming, is a direct enforcement state with no authority to enforce provisions of the Affordable Care Act.
The Centers for Medicare and Medicaid Services (CMS) intends to post information on proposed rate filings for consumers to review on https://ratereview.healthcare.gov on Aug. 1, 2017. In compliance with state statutes, OID cannot release or comment on the rates until that time. CMS officials will review the proposed rate changes, determine if they are justified and post final rate information on Nov. 1, 2017 in time for open enrollment.
According to the American Academy of Actuaries, individual market stability, including insurer decisions on participation for 2018, hinges on:
- Continued funding of cost-sharing reduction (CSR) reimbursements.
- Enforcement of the individual responsibility penalty.
- Risk mitigation mechanisms aimed at lowering premiums, increasing enrollment and improving the risk pool.
- Avoiding legislative or regulatory actions that could increase uncertainty or threaten stability.
State Question 756, passed in 2010, amended the Oklahoma Constitution to prohibit laws which compel individuals, employers and providers to participate in health care systems. Because of that legislative change, insurers offering products on the Oklahoma exchange are required to submit rate filing justifications to CMS for evaluation and approval.
History of Oklahoma Exchange Carrier Participation
2017 – Blue Cross Blue Shield
2016 – Blue Cross Blue Shield, United Healthcare
2015 – Blue Cross Blue Shield, Community Care, Global Health, Assurant
2014 – Blue Cross Blue Shield, Community Care, Global Health, Aetna, Coventry