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Blue Cross Lowers Rates For Affordable Care Act Plans Across NC

Blue Cross Blue Shield NC headquarters in Durham.
Blue Cross Blue Shield of North Carolina

After years of rising prices for Affordable Care Act health insurance plans, many North Carolinians are in for a nice surprise – a price decrease. Blue Cross Blue Shield of North Carolina says the state approved its request to lower rates an average of 4.1 percent across the state. In the Charlotte and Gastonia areas premiums could decrease by as much as 16.5 percent. The amount will vary based on the tax credits people qualify for.

This is the first time Blue Cross is reducing rates since it started offering plans in North Carolina on the marketplace in 2014. CEO Patrick Conway attributes these decreases to different payment arrangements with doctors and hospitals. Instead of paying providers every time a patient comes in, these providers will be paid based on how healthy they keep patients. Statewide, Conway estimates these arrangements will reduce medical costs by $120 million in 2019.

Conway said the deals Atrium has made with hospitals and doctors in Charlotte and Gastonia are more beneficial to patients.

“In Charlotte and the Triangle there is competition so we were able to engage with the various hospitals and providers in the state and say we need to partner to both lower rates and the total cost of care,” Conway said.

Credit Blue Cross Blue Shield NC

Premiums will increase in the eastern and western parts of the state, where there’s less competition. Blue Cross insures about 475,000 people on the marketplace in North Carolina. About a quarter of those customers are in the Charlotte and Gastonia areas.

Julieanne Taylor, who works with the Charlotte Center for Legal Advocacy and helps people sign up for health insurance coverage, said customers are excited that the benefit plans will be similar.

“They like the consistency of knowing that their doctors are in network every year and that the networks aren’t changing a lot,” Taylor said.

Conway said rates would have been cut even more if the Trump administration hadn’t continued to change parts of the healthcare law. This year, the individual mandate will be lifted and so will limits on short-term health plans. Last year, insurers raised rates to deal with uncertainty about the ACA’s future, said Sabrina Corlette, a research professor at Georgetown University.  

“They knew that there were all these risks to the ACA and so they increased their prices for 2018,” Corlette said. “And in many cases companies overshot the mark. So they priced almost too high and now we are seeing a correction.”

Two other insurers are offering plans in North Carolina next year: Cigna, which initially requested a rate increase of more than 3.6 percent, and Ambetter, which is new to the market. More than half a million North Carolinians bought health insurance plans on the exchange last year.