Nye is the only rural county in Nevada that will continue to have access to Anthem’s qualified health plans, after the insurer announced that it’s pulling out of 14 Nevada counties in 2018 because of the volatility in the state’s individual market.
Anthem, the only statewide carrier in Nevada, has reduced its footprint to Clark, Washoe and Nye counties, leaving residents in the remaining 14 rural counties without qualified health plans.
Heather Korbulic, executive director for the exchange, Nevada’s state agency that helps individuals get health coverage through the online marketplace, said for the last seven months, insurers across the country have been concerned about whether they will be paid cost-sharing reduction and whether the individual mandate, the penalty for those who are uninsured, will be enforced.
“Because there’s been no assurances whether cost-sharing reduction and individual mandate will be enforced, the carriers have been concerned. That’s part of why we are seeing coverage decrease in Nevada,” Korbulic said.
In a news release on June 28, Anthem said it made adjustments to the individual plans in Nevada for 2018 due to the continued volatility in the state’s individual market.
“Planning and pricing for Affordable Care Act-compliant health plans has become increasingly difficult due to a shrinking and deteriorating individual market, as well as continual changes and uncertainty in federal operations, rules and guidance, including cost-sharing reduction subsidies and the restoration of taxes on fully-insured coverage,” Anthem said in a news release.
Anthem has filed to offer on-exchange health maintenance organization plans in Clark, Nye and Washoe counties only for 2018. Additionally, a catastrophic medical plan will be offered off-exchange statewide, the company said.
“Recognizing the dynamics and level of volatility in the individual Affordable Care Act-compliant product offerings, the rates we filed in Nevada reflect increases in the cost of delivering medical services coupled with pharmacy expenses and overall increased use of health-care services by our members in Affordable Care Act plans,” Anthem said in the news release.
The plan changes will not affect people who purchased transitional individual or family health plans, otherwise known as grandfathered plans. Likewise, if a member receives their health insurance benefits from their employer, or if a member is covered by a Medicare Advantage or Medicare Supplemental plan, they will not be impacted by the changes.
The company’s plan offerings for dental, vision and life benefits also will not change and will be available to current members and new customers in 2018.
Officials look for solutions
Nevada now faces a health-care crisis in 14 rural counties where residents will have no access to subsidized qualified health plans through the Exchange based on plan-year 2018 health-care plan filings by insurance carriers.
The Exchange officials said the organization is now working with Nevada Gov. Brian Sandoval, the state Division of Insurance and Health and Human Services to identify solutions for more than 8,000 consumers in Carson City and 14 rural Nevada counties.
“I consider this a health-care crisis for rural Nevada, and it is extremely concerning to me that thousands of Nevadans may lose access to affordable health care,” Korbulic said. “Regardless of the uncertainty surrounding the future of health-care reform, the Exchange is focused on how to implement a successful open enrollment for plan-year 2018.”
U.S. Sen. Catherine Cortez Masto, D-Nevada, joined Sen. Jeanne Shaheen, D-New Hampshire, to introduce the Marketplace Certainty Act, that would stabilize the health-care market. The bill would prevent costs from spiraling out of control so that providers are not forced to leave markets.
“The decision by health insurers to pull out of Nevada’s rural counties, leaving nearly 8,000 Nevadans without coverage, is a direct result of the crisis of Republican leadership in Washington,” Cortez Masto said in a news release. “The bill I sponsored yesterday would end the chaos and allow health-care providers to continue offering affordable coverage in rural communities.”
Sandoval called the situation “unacceptable.”
“My administration is working diligently to identify solutions to ensure there is, at the very least, a safety net available to rural Nevada residents who will be left without any options for coverage in the wake of these devastating and unfortunate decisions,” he said. “The reduced footprint of carriers on the Exchange will leave more than 8,000 Nevadans with no coverage, and that is unacceptable.”
The expansion of Medicaid and subsidized qualified health plans in Nevada has helped to dramatically reduce uninsured rates. Officials said lack of coverage in rural Nevada will set back years of work to reduce the uninsured rate throughout our state.
Nevada officials react
Some members of the Nevada congressional delegation blamed the exit of Anthem from Nevada’s rural health care market on the actions of the Trump’s administration.
Cortez Masto said the situation is the result of Republicans and Trump’s threatening to repeal the Affordable Care Act and “toying with people’s health care.”
“Rural Nevadans struggle the most when it comes to access to affordable health care, and it is disappointing that President Trump’s reckless actions have led Anthem to reach a decision that will give Nevadans far less options for health care coverage that works for them,” Cortez Masto said.
U.S. Rep. Jacky Rosen, D-Henderson, said the exodus from Nevada’s health exchange creates a crisis for patients in rural communities who are already struggling with access to affordable health care.
“These health insurers pulling out of Nevada is a direct result of President Trump and Republicans in Congress creating partisan chaos over health care,” Rosen said. “The rush to pass this reckless legislation has already caused so much instability on the Exchange that thousands of rural families in Nevada will now have zero options.”
Sean Griffin, director of Community Chest, an organization that serves Lyon, Storey, Mineral and northern Nye counties, said Anthem’s exit will have “devastating” effects on rural Nevada.
“It gives people one last choice, and there were so few choices to begin with,” Griffin said about rural health care.
“I hope we can find a way to get it resolved proactively because it is leaving rural Nevadans in a lurch.”
Contact reporter Daria Sokolova at email@example.com. On Twitter: @dariasokolova77