Residents in 14 Nevada Counties Will Not Have Access to Qualifie - KTVN Channel 2 - Reno Tahoe Sparks News, Weather, Video

Residents in 14 Nevada Counties Will Not Have Access to Qualified Health Plans

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The Division of Insurance has announced that Nevada’s insurance carriers that participate in the Silver State Health Insurance Exchange have decided to only offer coverage to Clark, Washoe, and Nye counties beginning in 2018.

Currently these medical carriers offer plans on Nevada Health Link:

  • Health Plan of Nevada
  • Prominence Health Plan
  • Anthem 

But some changes are coming as of January 1, 2018.

  • Health Plan of Nevada will only be offering coverage in Washoe, Clark, and Nye Counties.
  • Prominence Health Plan announced this week that they will be pulling out of the Nevada Exchange market.
  • Two new companies, Aetna and Centene will be joining the exchange market but  according to the Division of Insurance at most they will only be offering plans in Washoe, Clark, and Nye counties

The Division of Insurance says this will leave about 8,000 Nevada residents without coverage across 14 counties. The largest group is about 5,000 people across  Carson City, Douglas, Lyon, and Storey Counties.

If you live outside of Washoe, Clark, or Nye counties and have concerns about your coverage, Silver State Health Exchanges suggests you call them at 855-768-5465.

They say that they are working diligently with Governor Sandoval to come up with a plan for those that could be uninsured.

KTVN has reached out to the insurance companies directly to ask about this decision.

  • Health Plan of Nevada says that a final decision hasn’t been made for their 2018 participation.
  • Prominence says that all 2017 plans will continue to be offered for the remainder of this year. They currently serve Carson City, Clark, Douglas, Lyon, Nye, Storey, and Washoe County.
  • Aetna says that there hasn’t been a final decision on their 2018 presence in Nevada yet.

Read Governor Sandoval and other Nevada representative’s responses along with the press release from Silver State Health Insurance Exchange.

Commissioner Barbara Richardson issued the following statement after the Silver State Health Insurance Exchange public board meeting announcement that residents in 14  Nevada counties will not have access to Qualified Health Plans (QHPs):

“The Division is disappointed and concerned that Nevadans in 14 out of the state’s 17 counties will not have access in 2018 to subsidies and cost sharing assistance provided under the Affordable Care Act. Four carriers have applied to offer plans on the Exchange in Clark, Washoe and Nye counties,” said Commissioner Richardson. “The Division has been flexible in working with carriers during this time of uncertainty in the health care market. This included working with carriers on an amendment to a bill that the Governor recently signed into law that allows carriers additional time to revise QHP applications.  We strongly encourage our Exchange carriers to expand proposed QHP service areas to ensure that all Nevadans will continue to have access to Exchange plans. The Division will continue to collaborate with the Silver State Health Insurance Exchange, the office of Nevada Governor Brian Sandoval and insurance carriers to come up with potential solutions to help Nevada consumers in the remaining 14 counties without a current Exchange product.”

U.S. Senator Catherine Cortez Masto (D-Nev) released the following statement in response to Anthem’s decision to pull out of Nevada’s healthcare market in 14 rural counties:
 
“The uncertainty caused by Republicans and President Trump threatening to repeal the Affordable Care Act and toying with people’s healthcare is resulting in health-insurers leaving critical markets, thus hurting Nevadans’ access to life-saving care and jeopardizing the lives of many. Rural Nevadans struggle the most when it comes to access to affordable healthcare, and it is disappointing that President Trump’s reckless actions have led Anthem to reach a decision that will give Nevadans far less options for healthcare coverage that works for them. President Trump’s efforts to sabotage the Affordable Care Act must stop at once. Expanding access to care must be our top priority, not giving tax breaks to the wealthiest Americans. I stand ready to work with Republicans to improve the current law and find solutions that work for all Americans, not just a few.”

Governor Brian Sandoval released this statement: 

“My administration is working diligently to identify solutions to ensure that there is, at the very least, a safety net available to rural Nevada residents who will be left without any options for coverage in the wake of these devastating and unfortunate decisions. I have communicated the news of this crisis to U.S. Health and Human Services Secretary Tom Price and the state will pursue all available options to help the individuals and families who will be hurt by this decision. The reduced footprint of carriers on the Exchange will leave more than 8,000 Nevadans with no coverage, and that is unacceptable,” said Governor Brian Sandoval. “The expansion of Medicaid and subsidized Qualified Health Plans in Nevada has helped to dramatically reduce uninsured rates for these individuals. Lack of coverage in rural Nevada will set back the years of work we have done to reduce the uninsured rate throughout our state. My office has been engaged with the carriers, the Exchange and the DOI and I am hopeful that we will find a solution that will benefit consumers in our state’s bare counties.”

Congressman Mark Amodei (NV-02) released the following statement after Anthem announced it will be pulling out of six counties in Nevada’s Second Congressional District:

“Sadly, this news isn’t shocking,” said Congressman Amodei. “It represents another symptom of the sickness that is killing America’s health care system. While there are plenty of arguments on how to fix this, regardless of your political views, it’s clear the status quo isn’t working and is in need of serious repair. Once again, I’m left wondering, when is Congress going to put the issue ahead of the politics? I will continue to focus on the facts and the policy options to be applied in Nevada. As always, my goal is to ensure that any reform package increases Americans’ access to quality and affordable care, while paying respect to rural communities like ours that are being hit the hardest.” 

Congresswoman Jacky Rosen (NV-03) released the following statement in response to insurance carriers pulling out of Nevada’s healthcare market:

“These health insurers pulling out of Nevada is a direct result of President Trump and Republicans in Congress creating partisan chaos over health care. The rush to pass this reckless legislation has already caused so much instability on the exchange that thousands of rural families in Nevada will now have zero options. This exodus from Nevada’s health exchange creates a crisis for patients in rural communities who were already struggling with access to affordable health care as it is. All signs point to President Trump and Republicans in Congress continuing to sabotage the Affordable Care Act for political reasons, which means we can only expect to see additional health insurers exit the Silver State Health Exchange. It’s time for Republicans to give up on this obsession with tax breaks for the wealthy and instead work across the aisle to work on finding real, bipartisan solutions to improve our health care system.”

Anthem, Inc. sent us this statement:

"Anthem Blue Cross Blue Shield has been serving consumers in the Individual market for decades, and throughout that time our commitment to the residents of Nevada to provide access to affordable, quality health care has not changed.  

"A stable insurance market is dependent on products that create value for consumers through the broad spreading of risk and a known set of conditions upon which rates can be developed.  We are pleased that some steps have been taken to address the long term challenges all health plans serving the Individual market are facing, such as improving the eligibility requirements that allow consumers to purchase a plan outside of open enrollment and improved risk adjustment. However, the Nevada individual market remains volatile, making planning and pricing for ACA-compliant health plans increasingly difficult due to a shrinking and deteriorating individual market, as well as continual changes and uncertainty in federal operations, rules and guidance, including cost sharing reduction subsidies and the restoration of taxes on fully insured coverage. 

"As a result of the continued volatility in the market, Anthem has made some adjustments to our 2018 Individual plans in Nevada.  For next year, we have filed to offer on-exchange HMO plans in Clark, Nye and Washoe Counties only.  Additionally, a catastrophic medical plan will be offered off-exchange statewide. This decision does not affect those who have employer based insurance or individuals enrolled in “grandfathered” plans (plans purchased before March 2010). 

"As the Individual marketplace continues to evolve, Anthem will continue to advocate solutions that will stabilize the market to allow us to expand to a more robust presence in the future."

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