Wellmark Blue Cross and Blue Shield had announced that it would enter the Iowa health insurance exchange in 2017 after years of watching the market unfold from afar, reported The Gazette.
The insurer will offer subsidy-eligible plans on the exchange that feature joint ventures with health systems and more expectable copays. Wellmark chose to go with this approach after observing the tumultuous health exchange landscape, particularly in the past three years.
“We saw a lot of products that had broad networks and not a lot of positive experiences for members. These products saw significant increase in premiums and other issues,” said Wellmark vice president of health networks Mike Fay. “We were committed to going onto the exchange and felt (2017) was the right year.”
Wellmark vice president for health care strategy and policy Laura Jackson likened the Affordable Care Act’s (ACA) design to Jenga; the ACA was designed with good intentions, but its important parts were taken away bit by bit by lobbyists and special interest groups, eventually rendering the law unstable.
Using the metaphor, Jackson pointed out that no one insurer can add stability, but Wellmark has watched and learned from other carriers. She believes the company can take a thoughtful approach in the plans it will sell on the exchange.
“So while some have pulled out of the marketplace, and whether this is sane or not, we have decided to double down,” she added.
UnitedHealth Group recently announced that it would exit from all but a select few state exchanges next year—Iowa was one of the states named.
Wellmark said that it had designed its exchange plans to better control premiums and offer enhanced outcomes. The company proposed an average base rate increase for individual ACA plans of 38% to 43% for next year, reasoning that the increases stem from serious health conditions.
The insurer will offer comprehensive 2017 plans during the upcoming open enrollment period, from Nov. 1 to Jan. 31, 2017. Wellmark had partnered with the University of Iowa Hospitals and Clinics and Mercy Health Network to form two new health insurance companies to facilitate proper care.
Wellmark will also sell tiered copay plans for more transparency with its consumers.