Florida Blue will remain in the individual insurance market

Frank Gluck
The News-Press
Healthcare.gov

Florida Blue, the state’s largest health insurer, will remain in the individual market for 2018 and offer plans this fall in all 67 counties on the Affordable Care Act's marketplace platform at healthcare.gov – assuming it still exists.

The company’s decision puts to rest concerns that it might join other individual-market insurers that have recently announced pullouts from some large U.S. markets.

Company representatives outlined Florida Blue's plans in an interview with The News-Press on Friday.

"We’re pretty confident that we can continue to serve the people of Florida and be a competitive force with whoever is in the marketplace." said David Pizzo, Florida Blue market president for the company's west region. "We only sell health insurance in Florida and this is our home, so we don’t have the luxury of pulling out or trying to target profitable counties. We’re in it for good.”

The company did not say what premium increases it will seek when it notifies the state of its intentions later this month.

Last year, Florida approved a 19 percent rate increase for Florida Blue. The average increase for all insurers was 19.1 percent. But those figures don't take into account the subsidies that about 93 percent of buyers received.

But Pizzo said the company will base its premium price requests on the assumption that the Trump administration will leave in place what are known as cost-sharing reduction (or CSR) payments to insurers. The subsidies help insurance companies to lower premiums, deductibles and co-payments for low-income policyholders. 

The Trump administration has not yet committed to continuing CSR payments.

Without them, Florida Blue estimates that premiums for individual market plans would jump about another 20 percent. 

The company has made the issue one of its top lobbying priorities as Congress continues to debate the possible repeal of the Affordable Care Act and drafts possible replacements.

"You’ve got 6 million people who are benefiting from them (CSRs) across the country, and 1.2 million of them are here in Florida," said Florida Blue spokeswoman Christie Hyde DeNave. "That’s a huge number. That’s 70 percent of the enrollees.”

Florida Blue has been the only company to sell Obamacare plans in all Florida counties and for some – including Lee and Collier – it is the sole provider in that individual market. The company accounted for about 1 million of the nearly 1.8 million exchange plans purchased statewide in 2017.

About 93,000 people living in the Fort Myers-Naples metropolitan area enrolled in marketplace plans for this year.

A number of large insurers have announced plans to exit markets in other states, potentially leaving tens of thousands without any insurance options.

This week, Anthem Blue Cross and Blue Shield announced that it would pull out of the marketplace in Ohio.

President Donald Trump on Thursday cited Anthem's decision as evidence that the Affordable Care Act is imploding. Anthem said its decision was the result of a "shrinking individual market as well as continual changes in federal operations, rules and guidance."

Insurers will notify the state about their participation in the individual market and their premium increase requests later this month.

Follow this reporter on Twitter: @FrankGluck