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Medica likely pulling out of ND insurance exchange next year

Jon Godfread (Rep) candidate for North Dakota Insurance Commissioner Special to The Forum

BISMARCK—Citing uncertainty around federal subsidies for health insurers, Medica will not offer individual coverage through North Dakota's Affordable Care Act exchange in 2018, the state's insurance commissioner said Thursday, Sept. 28.

Insurance Commissioner Jon Godfread, a Republican, said Medica's decision illustrates the instability of the Affordable Care Act exchanges. Still, he noted North Dakotans should still have options through Blue Cross Blue Shield and Sanford Health Plan.

"We still have competition in our marketplace, which is a good thing," Godfread said. "But this kind of goes to show that we're not immune from the issues with the ACA ... and why we were so hopeful for some federal reform coming out of D.C."

A Medica spokesman previously said discontinuing the federal subsidies, known as "cost-sharing reduction payments," would result in a premium increase that could be as high as 20 percent. The CSRs are made to insurers to help low-income people with out-of-pocket costs.

After filing rates with CSR funding included, Medica requested the North Dakota Insurance Department to approve premium rates for 2018 assuming CSRs would not be paid. But the department "has declined to approve any rates under this assumption," according to a news release.

President Donald Trump has derided the CSRs as "bailouts" and has threatened to cut them off.

In a statement, Medica spokesman Greg Bury said they hope that "if clarity can be provided by the federal government we, the department and (the Centers for Medicare and Medicaid Services) can quickly react and make the necessary changes so that Medica could be available as (an) option on the exchange in North Dakota next year."

Of the 20,691 people on the exchange, Medica provides coverage for 3,073, Godfread's office said. North Dakotans can still buy an individual health insurance plan from Medica outside the ACA exchange.

Sen. Heidi Heitkamp, D-N.D., who has cosponsored a bill to fund the CSR payments, said Medica's decision "reinforces why immediate action by Congress is desperately needed to fund the cost-sharing payments which help American families afford health coverage and provide certainty to the markets."

John Hageman

John Hageman covers North Dakota politics from the Forum News Service bureau in Bismarck. He attended the University of Minnesota in the Twin Cities, where he studied journalism and political science, and he previously worked at the Grand Forks Herald and Bemidji Pioneer.  

(701) 255-5607
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