Anthem Blue Cross started out as carrier with the largest enrollments in 2014 and 2015. They dropped to 26% market share in 2016. They dropped again 2017 down to 19%. Part of the drop, from my perspective, was related to the cost of the health plan versus their EPO network. People didn’t see the value of the smaller network and no out of network coverage relative to other alternatives. Then in 2018 Blue Cross pulled out of most of California. They offered plans only in region 1 (Northern California), region 7 (Santa Clara County) and region 10 (Central Valley counties). This dropped their market share down to 5%.
Covered California takes a dig at the federal government correctly pointing out that rate increases, because of the removal of the individual mandate, means the subsidy amounts for consumers in Covered California will increase, “…the federal government will end up paying an estimated $250 million more in higher tax credits.” The loss of consumers will also impact Covered California. They estimate that enrollment in Covered California could decrease by as much as 162,000 individuals. Covered California is funded by a health plan fee for every member who enrolls through Covered California.
As the date for the ACA open enrollment approached, most health insurance agents were nervous about what to expect and what role they might play in helping clients enroll in the new health plans. This anxiety was enhanced by the cold shoulder given them by Covered California and the health insurance companies in terms of training and information. At the end of open enrollment, many agents felt as if they had been abandoned by the carriers and Covered California while trying to help their clients. This has left some agents wondering if now is the time to organize into a guild and work for better training, enrollment tools and fair compensation for the assistance they provide to their clients.