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Regence pulling out of local exchange

Regence BlueCross BlueShield of Oregon will stop offering individual insurance in Jackson County on a government exchange in 2018 — leaving residents the choice of two insurers who are both seeking rate increases next year.

Five companies offered individual insurance on the exchange in 2016 in Jackson County, but that number dwindled to three this year and will drop to two beginning in January 2018, according to the Oregon Department of Consumer and Business Services.

For the insurers that will remain, Moda Health Plan is seeking a 13.1 percent rate increase for 2018, while Providence Health Plan wants a 20.7 percent increase.

Regence will no longer offer individual insurance via the exchange except in the Portland metro area starting in 2018. It is seeking a 17.2 percent rate increase.

It offers individual insurance on the exchange through its affiliate BridgeSpan in Jackson County.

Consumer and Business Services is reviewing the rate increase requests and will make a preliminary decision Friday, with a final decision expected in late July, said Jake Sunderland, public information officer for the state agency.

Moda, Providence and Regence all received rate increases of more than 20 percent for 2017. Moda pulled out of many rural counties this year, while Providence and Regence also made plans to leave but agreed to stay after the state granted additional increases, according to the Associated Press. 

People shop for individual insurance on the government-run exchange for a variety of reasons. Some don't receive insurance from an employer, are self-employed or have retired but aren't old enough to qualify for Medicare. Depending on their income, they can receive government subsidies to defray some of the cost of insurance bought via the exchange.

Jackson County customers have begun receiving notices from Regence that it will no longer offer individual insurance via the exchange in 2018. Regence is advising customers their coverage will continue through this year, but they must pick a new plan for next year.

Central Point retirees Pat and Anne Barry, ages 60 and 61 respectively, recently received a notice.

Three years ago, they each paid about $250 per month for health insurance bought off the exchange. Rates then increased to about $500 each. Barry said he now pays $655 per month and his wife pays $679 for high-deductible health insurance.

Before retiring, they had employer-provided health insurance. Now, Barry said, the repeated rate increases and uncertainty about future increases for exchange insurance make long-term planning difficult.

"It's not what we anticipated when we decided to retire," he said. "It's a little bit unsettling. We need health insurance. We've both experienced health issues. We're very thankful we have had health insurance. We can't go without it. It's not an option."

The government-run exchange was developed after passage of the 2010 Affordable Care Act. Many insurance companies underestimated the cost of caring for the waves of new patients, many of whom were sicker than expected and had a backlog of untreated medical ailments.

The Affordable Care Act set minimum standards for what has to be covered, including services such as maternity care and drug treatment, and said people with pre-existing conditions couldn't be denied coverage.

As health insurance premiums rose, many young, healthy Americans chose to pay a tax penalty rather than buy increasingly expensive insurance — leaving insurance companies with a sicker pool of patients that is more costly to treat.

Republican efforts to repeal and replace the ACA have caused uncertainty and roiled insurance markets further.

Insurers and the nonpartisan Congressional Budget Office predict reduced government subsidies and the proposed elimination of the federal mandate to have insurance will cause millions of people to lose insurance or choose to go without.

Jared Ishkanian, spokesman for the nonprofit Cambia Health Solutions corporation — which includes Regence and BridgeSpan insurance — said BridgeSpan individual health plans still will be offered on the government exchange for counties in the Portland metro area.

Existing coverage for members remains in place through 2017. The Portland-headquartered corporation is in the process of contacting members affected by the pullout in other counties around the state, he said in a statement.

"Despite unprecedented market uncertainty, we are continuing to support the individual market," Ishkanian said in the statement. "Oregon is our home, and we are committed to its economic success, but we need to participate in a sustainable way while working to address the real cost of care. We will continue discussions with regulators about advancing solutions that offer dependable and affordable health insurance choices for Oregonians going forward, and work collaboratively with our provider partners on innovative care arrangements that better serve consumers’ needs."

Meanwhile, in 2018 Regence is also discontinuing an individual insurance product it offered outside the government exchange in Jackson County. People who buy that individual insurance do not receive subsidies to help them afford coverage, according to the state.

— Reach staff reporter Vickie Aldous at 541-776-4486 or valdous@mailtribune.com. Follow her at www.twitter.com/VickieAldous.