BCBS of Kansas City Will Leave ACA Health Insurance Exchange

May 30, 2017 - The exit of Blue KC from the ACA health insurance exchange in 2018 will affect a 32-county service area in Kansas and Missouri, and leave both urban and rural counties without any marketplace exchange insurers.

The payer blamed losses exceeding $100 million in 2016, and concluded staying in the exchange was not a sustainable business plan.

“Since 2014, we’ve expended significant resources to offer individual ACA plans to increase access to quality healthcare coverage for the Kansas City community,” said Danette Wilson, President and CEO of Blue KC.

“We have a responsibility to our members and the greater community to remain stable and secure, and the uncertain direction of this market is a barrier to our continued participation.”

The marketplace departure will affect around 67,000 members. 

Since 2016, the Kansas City area has seen a precipitous decline in payer participation. Humana and Cigna exited the market, leaving Blue KC as the sole insurer. 

Blue KC currently offers coverage in 30 counties in western Missouri, along with two counties in Kansas. In 25 of the 30 Missouri counties where Blue KC offers coverage, they were the only carrier participating in the exchange for 2017.

The ACA health insurance exchange departure will not affect individuals who are in plans purchased on or prior to October 1, 2013. 

Blue KC also stated that members covered through employers, or Medicare Advantage, Medicare Supplement, short-term or student health plans will also not be affected.

“This decision is necessary at this time, but we’ll continue to work with federal and state legislators to identify solutions that will stabilize the individual market and bring costs down for our members, the community and Blue KC,” said Wilson.

This follows a  recent move by a separate division of BCBS into the Knoxville, Tennessee 2018 marketplace just a few week prior.

The payer’s move into the vacant ACA marketplace positioned BCBS as the sole insurer for 16 counties in the greater Knoxville area.

The region was left without an insurer when Humana pulled out of the individual health insurance exchanges for 2018.

After three difficult years, and losses totaling more than $400 million, the decision by BCBS to expand into the Knoxville market was based on better-than-expected 2017 results. 

“I’m pleased to report that, though still very early, our 2017 performance has improved due to a combination of better claims experience and a more sustainable rate structure based on the medical needs of the members we’re serving.” “ said JD Hickey, President & CEO of BCBS Tennessee