Chattanooga, Knoxville and two-thirds of Tennessee's 95 counties will have only one insurance provider offering individual health insurance plans under the health exchange markets next year, according to filings with the Tennessee Department of Commerce and Insurance released Wednesday.
BlueCross BlueShield of Tennessee, which withdrew from the state's three biggest markets this year to limit its losses from Obamacare, has agreed to resume service to Knoxville to ensure that all counties have at least one carrier.
Cigna Health Insurance plans to continue offering plans in Memphis and Nashville, but other major insurance companies, including Humana, Aetna and United Healthcare, have pulled out of Tennessee's individual market over the past several years.
But Tennessee has attracted a new insurance provider that was founded by the brother of President Donald Trump's son-in-law, Jared Kushner.
Oscar Health Insurance, a New York-based company founded by Joshua Kushner, Mario Schlosser and Kevin Nazemi, is offering to provide an individual plans in the Nashville market area. Oscar is a subsidiary of Mulberry Health Inc. and is expanding into Tennessee, Ohio, Texas, New Jersey and California next year.
"Why seek to expand in a time of uncertainty?" Mario Schlosser, CEO and co-founder of Oscar, asks in a new blog post about the company's 2018 plans. "We're confident that when the dust settles, the market for health insurance will stabilize in time for 2018. For all of the political noise, there are simply too many lives at stake for representatives in Washington, D.C., not to do what's right for the people."
Schlosser said the company decided to enter the Nashville market, which he said "is laying claim to its status as the country's capital in health care technology and innovation, and always seemed like a natural fit for Oscar.
"While it's a completely new market for us, we'll be working closely with regulators to see if we can deliver a competitive product in Nashville's individual market, and are filing for expansion there in 2018," he said.
The Chattanooga- based BlueCross, Cigna and Oscar notified the Tennessee Department of Commerce and Insurance (TDCI) of their intent to offer individual health insurance coverage on and off the Federally Facilitated Marketplace when Open Enrollment begins for 2018 on Nov. 1, 2017.
Tennessee Insurance Commissioner Julie Mix McPeak said she is "pleased that there would be no uncovered areas in Tennessee" but she said "the market remains challenged as most Tennessee consumers will still face limited options and increasing premium prices.
"The uncertainty about the future of the exchange, cost-sharing reduction payments, and enforcement of the individual mandate will likely increase carrier rate requests by 15 to 20 percent above what they would have otherwise filed," she said. "I share consumers' frustrations about federal uncertainty and how that is impacting their ability to afford insurance."
Supporters of Obamacare blame the Trump administration for not enforcing the individual mandate to buy insurance and taking other steps to help maintain the health exchange markets.
"Republicans in Congress and in the Administration are injecting uncertainty into the marketplace purely for political gain," said Leslie Dach, director of the Protect Our Care Campaign. "The end result is higher premiums and fewer choices for consumers."
Nationwide, enough insurers are planning to sell coverage on the Affordable Care Act's insurance exchanges next year to keep them working - if only barely - in most parts of the country.
Competition in many markets has dwindled to one insurer - or none in some cases - and another round of steep price hikes is expected to squeeze consumers who don't receive big income-based tax credits to help pay their bill.
"What we're seeing is a deterioration in these markets, but the markets haven't imploded, they haven't gone into a rapid downward decline," said Dan Mendelson, president of the consulting firm Avalere.
Health insurers had until Wednesday to declare whether they planned to sell coverage next year on exchanges in most states. Actual participation and final rates won't be set until late summer or closer to the Nov. 1 start of enrollment for next year's coverage.
Early plans filed by many insurers for next year include premium increases well over 20 percent, and Avalere expects more than 40 percent of U.S. counties to have only one insurer selling coverage on the exchange, the only place where shoppers can get tax credits to help pay the bill. Some counties in Missouri, Ohio, Indiana and Washington will have none if another insurer fails to step in.
The early picture for 2018 looks much like it did for previous years: Insurers are retreating from some markets or charging a lot more to stay in others.
Nationwide, prices for individual insurance could rise between 28 and 40 percent on average, according to a prediction by Oliver Wyman Actuarial Consulting.
Most of that expected increase reflects concerns over how President Donald Trump's administration will manage the program, the consulting firm said. It may stop enforcing a mandate that most Americans buy coverage or it may halt cost-sharing payments that soften expenses for people with modest incomes. The mandate is seen as crucial to encouraging healthy people to enroll and balance the costs an insurer incurs from people who use their insurance.