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 The leading web portal for pharmacy resources, news, education and careers November 20, 2017
Pharmacy Choice - Pharmaceutical News - ACA collapse could uninsure 70,000 in Va. - November 20, 2017

Pharmacy News Article

 9/13/17 - ACA collapse could uninsure 70,000 in Va.

ROANOKE - The Affordable Care Act exchange is collapsing in Virginia, with the last potential insurer pulling out of western Virginia and leaving about 70,000 people without the ability to purchase health insurance for 2018.

"Any individual, regardless of income, who purchased an individual policy - on the exchange or non-exchange - won't be able to buy a policy next year," Carilion Clinic Chief Financial Officer Don Halli will said Tuesday. "When people think of the exchange, they think of poor people. That's not accurate. It's all income levels."

Should nothing change before the Centers for Medicare and Medicaid's Sept. 27 deadline for insurers to participate, parts of Virginia will be the only places in the U.S. without at least one insurer, according to an analysis by the Kaiser Family Foundation. Open enrollment starts Nov. 1 for policies that take effect Jan. 1.

But this spring, Aetna announced that it would no longer participate in the marketplace. Last month, Anthem followed suit. And Optima Health said last week that it would no longer offer individual policies in areas of Virginia where its parent, Sentara Health, does not have hospitals and providers. Optima had been expected to fill the void after Anthem announced its departure, meaning it would have been on track to sell 100 percent of the individual policies in the region.

Insurers blame President Donald Trump for making subsidies unreliable and Congress for failing to stabilize the market.

Virginia Secretary of Health Dr. Bill Hazel said Tuesday that Washington had manufactured this crisis, which will affect about 70,000 of the 350,000 Virginians who purchase policies on the exchange.

"They are the ones who have to fix it," he said. "Our hands are all but tied."

Hazel said he has been meeting with Virginia insurers, but none is willing to reenter the market as long as federal cost-sharing reduction payments are at risk. The payments are subsidies to lower-income people to help cover out-of-pocket expenses of high deductibles, co-payments and coinsurance.

Without the subsidies, insurers say healthier individuals would be unable to afford to use insurance coverage and so would opt to go without, leaving the insurers to cover only the sickest and costliest individuals.

Trump has called the subsidies an insurance bailout, has threatened to cut them off and let the ACA collapse, and has decided on a monthly basis whether to continue the payments.

"My members are large organizations that work with long-term planning. They make decisions based on years, not months," said Doug Gray, executive director of the Virginia Association of Health Plans.

Trump and Congressional Republicans this year failed in two attempts to replace the Affordable Care Act and have also failed to stabilize the market, Gray said.

"We didn't get into this by accident. It was by a conscious choice of leadership," he said.

© © Copyright 2017, The Daily Progress, Charlottesville, VA

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