North Carolina’s Obamacare exchange insurance market is in crisis mode. The state’s 100 counties will have 1.05 insurance carriers offering government approved plans to people who purchase health insurance on their own in the non-group market. 80 percent of North Carolina exchange enrollees will have Blue Cross and Blue Shield (BCBS) as their only health insurance provider. The rest will have BCBS or Cigna to choose from in five counties that make up the Research Triangle Region (hence the 1.05 number).
As it’s going to take an act of Congress to fix Obamacare and its skyrocketing health insurance premium problem – whether that means a smoother transition to single-payer, repeal and replace with ‘Obamacare Lite’ proposals, or completely restart the way health care is delivered as if Obamacare never existed, states can actually take charge and implement policy changes of their own without federal dictates that will help mitigate the effects of unaffordable health insurance.
For starters, state legislators could take a look at North Carolina’s 57 health insurance benefit mandates that are embedded in every small group and non-group policy sold in the state. Adding benefit mandates increases insurance premiums for everyone, regardless if policyholders never use them. Obamacare opponents do a pretty good job bashing the law’s ten essential health benefits that are to be included in health plans. Is a pediatric dental benefit mandate beneficial for a woman without children? How about maternity and newborn care for a male? Let’s keep the momentum going at the state level.
North Carolina has a plethora of mandates that don’t fit the interests for certain policyholders (i.e. marriage therapists, pastoral counselors, nurse midwives, social workers, or optometrists). However, they do fit the economic benefit for special interest groups that have successfully lobbied the North Carolina General Assembly to pass legislation in which their service is going to be reimbursed by insurance companies.
Throughout North Carolina’s legislative sessions, a number of bills have been filed calling for insurers to expand coverage to include benefits such as oral cancer drugs, autism therapy, and chiropractic care. The Associated Press reported that the introduced bills could amount to an additional 16 percent rate increase if passed. Keep in mind this doesn’t factor in Blue Cross and Blue Shield’s ask for an average 18 percent increase in premiums due to Obamacare’s instability.
But not all policyholders are subject to the state’s coverage mandates. Self-insured companies are exempt along with those that receive health benefits through the State Health Plan. And guess what? One could argue that both large self-insured plans and the State Health Plan offer generous coverage for their workers. Sans state mandates.
For more information on how North Carolina can be proactive in controlling health care costs, be sure to check out the North Carolina Coalition for Fiscal Health.
