Cigna will offer health insurance in Arizona, Colorado, Florida, Tennessee, and Texas health exchanges in 2014. However, Cigna currently offers individual and family plans in these states plus California, Connecticut, Georgia, North Carolina, and South Carolina. So this is a 50% reduction for Cigna. It is expected other carriers like Blue Cross Blue Shield and United Health will do the same and cherry pick their exchange markets. This will all lead to a reduction in options for the estimated 56% of Americans who will be shopping for health insurance on the exchange.
While some may find this alarming, the real concern with heath care reform may be finding a provider and having access to a number of doctors. Cigna also announced it will only offer plans in about a dozen metropolitan areas in the states they will service. If we look at a state like Colorado, one would expect Denver to be the only area offered Cigna coverage through the exchange. If we review Arizona, most likely it will only be in the Phoenix area. Tennessee may have Chattanooga, Knoxville, Memphis, and Nashville. Texas will surely have Austin, Dallas, Houston, and San Antonio. And Florida will have a number of metropolitan areas. One could even guess, that Cigna will be lining its new exchange plans in line with it’s Medicare networks and with Health Spring.
So what does all this mean to you? The tides are turning and it may turn to such a system that people living in the city will have access to the most affordable health care. Much of this is due to the strict schedules and limited time doctors are spending with patients, and of course many patients no longer see their doctor at all and ususally only see a nurse practitioner.
The exception to this would be California. California is a booming economy but companies like Cigna will not be on the California health exchange. Evidently, CA healthcare costs seem to be scaring away carriers like Cigna.
Essentially, Obamacare needs to accomplish two goals to be a success. First, people must be able to afford the plan. If the subsidies are substantial enough, this may work. It just depends on how much money the Federal Government really has? Secondly, will Americans be able to access doctors and hospitals, which shrinking networks seem to be the new trend. As far as the fine details as to enrollment, subsidy amount, and what Obamacare actually covers…..well, much of that is still up in the air or hidden somewhere in the stack of paper known as the Affordable Care Act.
What can the average American do?
Going forward having health insurance is going to be more like doing your taxes….or maybe like being your own boss and self-employed and doing your taxes. Preparation and guidance is going to be key. It would be a shame to be a family of four that earns $95,000 and get no subsidy to only discover all you had to do was work a few hours less overtime and you’d qualify for several thousand dollars of subsidy. Or even worse, some Americans will just keep doing what they are doing and not capture the entitlements that President Obama has aligned for them.
Probably the biggest concern about this entire process is funding. If 56% of Americans are getting subsidy. That leaves 44% to pay the bill. If the 44% are clever they may ease off their earnings to capture some of the subsidy. Realize the subsidy is not going to be $20 or $30 a month we’re talking about several hundered dollars of subsidy per a month for most Americans.
2014 is certainly a year of trial and error for Obamacare, health carriers, doctors, and you!