North Carolina Obamacare Insurer: Older, Sicker Mix Than Expected May Hike Premiums
A top insurer in the North Carolina Obamacare exchange reported that its customers are both older and less healthy than it expected and warned that premiums are likely to rise next year.
“Not as many of the state’s young and healthy enrolled as expected,” Blue Cross Blue Shield of North Carolina announced in a press release. The company expected 50 percent of its Obamacare exchange customers to be younger than 35, but just 32 percent of customers are below age 35 and just 25 percent are between the ages of 18 and 34.
With the fifth-highest number Obamacare sign-ups in the country, the health of North Carolina’s market is especially significant to the health care law’s success. According to the Obama administration’s most recent numbers, North Carolina signed up 357,584 people for coverage. Of that total, Blue Cross Blue Shield has a total of 232,000 “actual enrollees” as of May 1.
Even worse, the insurer believes that its few young invincible sign-ups are less healthy than expected as well.
“Early self-reported data indicates that BCBSNC’s young ACA customers (ages 18-34) are less healthy and seeking more medical treatment than we typically see in this age group,” according to the statement.
According to customers’ self-reported assessments, North Carolina’s customers have a higher percentage of chronic, costly illnesses such as diabetes, depression and asthma.
“Customers with conditions like this cost six times more than enrollees of similar ages without chronic conditions,” the insurer emphasized.
North Carolina’s not the only state struggling with few young sign-ups. A Thursday report from the free-market American Action Forum found that West Virginia, Oregon, New Mexico and Arkansas are also facing dangerous imbalances between typically less costly customers, those between the ages of 18 and 35, and the most expensive customers, those between 45 and 64.
Blue Cross Blue Shield is also worrying about new complications that could arise over the next year that will hike premiums even more. They insurer is watching to see whether most customers continue to use health care services at higher rates than expected.
Dropped policies are also a leading concern for the insurer.
“Some new customers may use their benefits early and then quickly drop coverage,” Blue Cross warned. Overall enrollment drop if customers pay premiums for only a month or two while receiving services and then drop out.
The nonpayment policy under the health care law has been drawing increased attention from insurers and doctors. When a customer fails to make a premium payment, Obamacare prevents insurers from canceling his insurance policy for 90 days. For the first 30 days, insurers will have to cover any health care services the customer uses; in the last 60 days, doctors will be on their own to wrangle payment out of a customer who is no longer insured.
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