Blue Cross and Blue Shield of Nebraska, the state's dominant health insurance company, said Friday it will not sell individual plans on the insurance marketplace for 2017. However, it is not a full exit, as the insurer will keep a small presence in the off-exchange market.
The departure marks a blow to the thinning Nebraska marketplace and gives Republicans firepower to rail against the law. But the decision from Blue Cross and Blue Shield of Nebraska is almost identical to what Blue Cross and Blue Shield of New Mexico did last year. Citing financial difficulties, the New Mexico Blues bailed from the on-exchange plans but still kept an off-exchange presence.
Maintaining some kind of footprint in the marketplace is crucial for being able to play again. A full withdrawal of all on- and off-exchange plans will lead to a five-year ban from re-entering. Blue Cross and Blue Shield of Nebraska will keep bronze and catastrophic plans in the off-exchange market but will dump all other plans that presumably had higher-cost members. It may return to the market in 2018, a spokeswoman said.
Other Blues affiliates, like those in Illinois, Minnesota and Texas, have scrapped their ACA plans with broad networks in favor of narrow-network plans.
Blue Cross and Blue Shield of Nebraska lost $140 million since it started selling plans on the Affordable Care Act exchange, the company said. The decision to exit the on-exchange individual market now leaves two insurers in the state, Aetna and Medica.
"We have a responsibility to all our members to remain stable and secure, and that responsibility will be at risk if we continue to sustain losses due to our participation in the ACA marketplace," the insurer said in a statement.
Financial filings show that Blue Cross and Blue Shield of Nebraska had 64,900 individual members at the end of 2015, both on and off the exchange. The underwriting loss that year was $39 million.
The Nebraska Blues ended 2015 with $1.65 billion in revenue from its fully insured products and a net loss of $31.5 million, according to the financial filings.