Iowa, South Dakota Blues Skip Obamacare Exchange Next Year

Blue Cross and Blue Shield plans, with a long history of selling medical insurance directly to consumers, are expected to provide much of the subsidized coverage sold through the health law’s online marketplaces, or exchanges.

“We expect Blue Cross Blue Shield plans will have a strong, reliable presence in the new exchanges,” Alissa Fox, a senior vice president at the Blue Cross and Blue Shield Association, recently told KHN. “We’ve been in this market for more than 80 years, and we’ve been providing coverage in every zip code to everybody. We imagine we will continue to do that.”

But on Monday Iowa and South Dakota became the second and third states in which there may be no Blues option when exchange consumers start shopping on Oct. 1. Citing concerns about its ability to deliver quality service as the marketplace ramps up, Wellmark Blue Cross and Blue Shield said it won’t offer subsidized plans through those exchanges until 2015.

“Given what we know today, we do not believe during the first year of the public exchange we could ensure the exceptional level of service our members have come to expect from Wellmark,” said the company’s statement. “For this reason, we have decided it is in our members’ best interest to delay our participation in the public exchange until 2015.”

Wellmark, which owns about 80 percent of the individual health-policy business in Iowa and about 70 percent in South Dakota, will continue to sell unsubsidized individual policies in those states. Six companies filed to sell individual plans on the Iowa exchange, two of them statewide, the Iowa Insurance Division announced Monday.

The fewer insurers that sell through exchanges, the less competition there will be for customers through price and service. Many insurers are approaching the exchanges cautiously because of concerns that the technology may not be ready and that the first customers will be disproportionately sick and expensive, analysts say.

Last month in Mississippi, Insurance Commissioner Mike Chaney disclosed that in some counties no insurer would offer subsidized coverage and that the Mississippi Blues had not applied to sell through the exchange.

“At this time we do not have any comment regarding our participation in the exchange,” said a spokeswoman for BlueCross BlueShield of Mississippi.

The Blues are a federation of insurance plans that were pioneers in health coverage in the years before World War II. A spokeswoman for the Blue Cross and Blue Shield Association referred queries about Iowa, South Dakota and Mississippi to Blues affiliates in those states.