1.4 million feared to lose policies as insurers exit

Health law’s options shrinking, officials say

NEW YORK -- A growing number of people who have health insurance under the Patient Protection and Affordable Care Act are finding out their plans will disappear from the program next year, forcing them to find new coverage even as options shrink and prices rise.

At least 1.4 million people in 32 states will lose the plans they have now, according to state officials. That's largely caused by Aetna, UnitedHealth Group and some state or regional insurers quitting the law's markets for individual coverage.

Sign-ups for coverage under the federal health plan begin next month. Fallout from the insurer departures has emerged as the latest threat to the law, which also is an issue in the presidential election. While it's not clear what all the consequences of the insurer departures will be, interviews with regulators and insurance customers suggest that plans will be fewer and more expensive, and may not include the same doctors and hospitals.

It also may mean that instead of growing in 2017, the number of people enrolled under the health care program will shrink. As of March 31, the law covered 11.1 million people; an Oct. 13 S&P Global Ratings report predicted that enrollment next year will range from an 8 percent decline to a 4 percent gain.

Last year in Minnesota, Theresa Puffer, 61, signed up for a Blue Cross and Blue Shield plan after leaving her job after a skin cancer diagnosis. "I would have had a hard time finding any sort of coverage before the [health care law]," Puffer said by phone.

Next year, Puffer's plan is disappearing, making her one of about 20,000 Minnesotans in the same situation. To make matters worse, premiums for other plans in the state will rise by at least 50 percent, though subsidies under the law can help cushion the blow.

"Trying to determine which would be the best plan for my situation is not easy," Puffer said. Her dermatologist appears to be out of network in other plans, she said. "I'm willing to pay a higher premium to see him, because when you have cancer you want to stay with the same group of doctors," she said. "I've spent so much time trying to figure out what my options are."

Bloomberg contacted officials in all 50 states and Washington, D.C., and the 1.4 million-person estimate encompasses 32 states and only plans sold on the individual "exchange" markets. In Texas, Arizona, Georgia and Missouri, insurers have pulled out, but regulators couldn't or wouldn't say how many people are affected. Three states didn't provide sufficient data. Eleven states and D.C. said they weren't affected.

The U.S. agency that oversees the Affordable Care Act has said some disruption is normal and that choosing new plans can help people get the best deal.

"It's part of the normal business cycle for insurers to discontinue, change, and replace plans from year to year," Benjamin Wakana, a spokesman for the Department of Health and Human Services, said by email Oct. 5. "Such changes don't prevent people from obtaining coverage. People can shop for new coverage through a transparent market."

The department said Thursday that it will contact people losing their coverage and encourage them to sign up with new plans. The law requires all Americans to have insurance or pay a fine.

Nationwide estimates of the number of people losing their current plans are higher. For example, Charles Gaba, who tracks the law at ACASignups.net, estimates that 2 million to 2.5 million people in the U.S. will lose their current plans, compared with 2 million a year ago. Gaba's estimate is based on insurance company membership data.

For the people losing plans, there are fewer choices. One estimate by the Kaiser Family Foundation predicts that for at least 19 percent of the people in the health care program's individual market next year, there will be only one insurer to choose from.

In North Carolina, for example, a Blue Cross and Blue Shield insurer will be the only option in 95 of the state's 100 counties after Aetna and UnitedHealth said this year that they would leave. That will leave 284,000 people looking for a new plan, according to the state.

In Tennessee, UnitedHealth and the state's Blue Cross and Blue Shield plan are pulling back, and about 117,000 people will lose the plans they have now.

Amanda Page Carpenter, a 34-year-old musician and athletic trainer in Nashville, is among them. For 2015, Carpenter was careful to pick a Blue Cross and Blue Shield plan that covered specialists at Vanderbilt Health, to treat nerve pain stemming from a 2013 accident. Her condition worsened recently, she said, and she's worried about losing access to her doctor.

"I'm hopeful that he's going to be able to help me," she said of her current physician. "I feel like now I have 2½ months to figure it out before they shut me out."

A Section on 10/16/2016

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