How Is Obamacare Affecting Competition Among Health Insurers?

By Alex Wayne | March 18, 2014

  • March 18, 2014 at 1:54 pm
    Whodathunkit? says:
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    In our area we have sold over 200 plans and 99.8% have been with one company because they have the best plans and by far the best rates. When the list comes up on the Marketplace (sorted by premium) we don’t see another company for the first 15 plan choices. Not sure how that will work out in the long run, but right now there is little competition.

    • March 18, 2014 at 2:41 pm
      Agent says:
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      Greater Transparency, right? The way they could have increased the competition between carriers would be to let them sell across state lines like P&C carriers have been doing for years. That was not part of the agenda so we really don’t have much competition in the states and some only have one choice available.

      • March 18, 2014 at 4:12 pm
        Ron says:
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        Agent,

        I am not looking for an argument, but doesn’t Blue Cross/Blue Shield, Aetna, United Healthcare, Cigna, and Humana all sell in multiple states? There may be more, but I believe at least these do. What exactly do you mean by allowing them to sell across state lines that does not currently apply to P&C companies?

        • March 18, 2014 at 5:19 pm
          Agent says:
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          Looks to me like you are looking for an argument Ron. If you have ever moved and had a Health policy written in one state, they would tell you to get a policy approved in the state you are moving to. In P&C, you also have to get a new policy written like Auto or Home, but if you are lucky and are with a national company, they will usually re-write your coverage in the same company you had. Terms may be slightly different with limits & coverage, but at least you can keep your policy if you like it with the same carrier.

          • March 19, 2014 at 9:35 am
            Libby says:
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            Explain how that is different than what happens in the health insurance arena. When I moved to a new state, I had to rewrite my auto insurance using rates that applied in the new state. Although my carrier was willing to quote me, they weren’t necessarily the best product at the best price, so I moved it. How is that different from health insurance?

            A sincere question, so no need to get all snippy with me.

          • March 19, 2014 at 10:23 am
            Ron says:
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            Agent,

            I am not sure why you think I was looking for an argument. I specialize in P&C. By your posts, I was under the assumption you have expert knowledge about health insurance.

            I really am ust asking an honest, sincere question to gain a little more knowledge and you really did not answer my question. As Libby pointed out, if you move from one state to another, your P&C policy will need to be rewritten, assuming your P&C carier is licensed in the new state. From a regulations standpoint, it will be considered new business giving the company the option to cancel the policy in the new state for any reason.

            If I move to a new state, is it the government requiring the health insurance company to approve me or is it the company’s decision?

            If you do not know the answer, please let someone else explain it. There is nothing wrong not knowing everything.

  • March 18, 2014 at 4:20 pm
    Whodathunkit? says:
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    Ron, it’s not transportable from state to state like your auto or your homeowners if you’re with a national company.

    • March 19, 2014 at 9:55 am
      Ron says:
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      Whodathunkit?,

      P&C is no more transportable. Those also need to be rewritten if you move to a different state. And if your carrier is not licensed in the new state, no policy. Please name me one personal lines carrier that will just change the location address in a state to state move?

      • March 19, 2014 at 10:16 am
        Whodathunkit? says:
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        Granted it’s not just a transfer, but as an insured you are treated as a long term customer not subject to many of the underwriting rules that apply to new customers. I moved 5 times and have had SF for all the moves and it has been seemless. I’m moving again in June (witness protection, just kidding) and will have to apply for new health coverage with a totally new company as a new customer. Not the same as getting my auto and homeowners from SF.

        • March 19, 2014 at 10:32 am
          Ron says:
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          You and Agent are not answering my question.

          If health insurance cannot be sold across state lines, why are there national health insurance companies that sell in multiple states?

          P&C companies cannot sell across state lines either. They both are regulated at the state level. For both, your policy needs to comply with the laws in which you reside.

          From the company’s standpoint your are treated as a long-term customer, same as in health insurance, but from a regulatory standpoint, every time you moved, you are considered new business and SF could have cancelled the policy for any reason. They did not because they view you as a profitable risk. If they wanted to cancel your policy, they could have.

          Try moving to a state in which SF is not licensed or writing new business and see what happens.

          Is your current health insurance company licensed in the state to which you are moving?

          • March 19, 2014 at 10:41 am
            FFA says:
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            Ron, My situation – I am with Blue Cross of IL. If I move to WI, I have to reapply in WI and give up my BCBS of IL policy.

            My doc network associated does not exist in another state.

            Sf honors rewrites with the longevity discounts applied in all operating territory unless the risk has changed substantially (Get a DUI that gets uncovered when they rerun your new DL# in your new state).

            With no underwriting for Health Insurance any more, the only thing I can see that matters is getting the network correct.

          • March 19, 2014 at 10:41 am
            Whodathunkit? says:
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            I did move to Mass. and SF assisted us in being placed with another company since they were not writing there. We were treated a loyal customers.

            I’m not sure about Aetna, but BC/BS of PA is not the same as BC/BS of Tenn, etc.

          • March 19, 2014 at 11:00 am
            Ron says:
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            FFA,

            My question is this, how can there be national health care companies if health care companies cannot sell across state lines? It sounds like it is the same as P&C.

            Is it the government preventing BCBS of WI from allowing you to access your doc network from BCBS of IL or is it BCBS who makes that decision?

          • March 19, 2014 at 11:14 am
            Libby says:
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            FFA – why would you want the same network in WI that you had in IL? Would you really travel that far to see the doctor?

          • March 19, 2014 at 11:23 am
            FFA says:
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            Ron, Govt regulations on health are state by state. BCBS nor the govt don’t tell me I cant go out of network. They just tell me I am going to get hit with heavy out of network penalties.

            I am not too sure how I would feel some person at a call center picking my doc for me that is who knows where. I much prefer someone with local knowledge.

            I did take the Blue Choice network which have a limited number of docs in the network. My PCP is in network. Got to go. Be back soon.

          • March 19, 2014 at 11:36 am
            Ron says:
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            FFA,

            I understand that health care regs are state-by-state. That was my point. I just do not understand the push to allow health insurance companies to sell across state lines when it appears that they already can. As I mentioned in a different post, are those people actually advocating for federal health insurance regulation instead of by the states? That would be the only thing different than what currently exists.

            That is my point.

          • March 19, 2014 at 12:15 pm
            Libby says:
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            FFA: Government regulations on P&C are state by state, too.

          • March 19, 2014 at 1:58 pm
            FFA says:
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            Me, personally, my opinion – I would be dead set against Fed Regulation of anything insurance related. They cant manage their own house properly. Nothing but a bunch of morons in DC right now. They would only screw everyone if they took over federal regulation. His appointment of a federal Ins Commis from IL???? Can only mean doom & gloom for our industry.

            I have no faith at all in the Fed Govt especially with OBama calling the shots. He is nothing but a bumbling bafoon making shit up on the fly.

          • March 19, 2014 at 2:38 pm
            Ron says:
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            FFA,

            I totally agree.

            However, we have had issues with federal regulations well before, and likely to continue after, President Obama. I know you don’t like to look back, but it was President Nixon who created the EPA. Maybe the worst federal regulator.

          • March 19, 2014 at 4:21 pm
            Whodathunkit? says:
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            The article is about competition. If BC/BS of PA is participating in all 50 states along with all the other BC/BS companies you get increased competition. With that you get more competitive pricing and better servicing. Unfortunately with the ACA they have eliminated the possibility of some interesting plan designs and plans targeted to specific groups, like women no longer of child bearing age, teenagers, etc…

          • March 19, 2014 at 4:42 pm
            Libby says:
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            Why would Blue Cross want to compete against itself? If there is a BC/BS PA, there’s probably a BC/BS in 49 other states. But isn’t it all BC/BS?

          • March 19, 2014 at 6:34 pm
            Don't Call Me Shirley says:
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            Whodathunkit, are you implying that BC/BS of PA was previously writing in other states, and now, because of the ACA, they no longer do that? Or is it just preferable to blame the ACA for decisions made by individual companies, of their own free will? While I agree this is a mess, a lot of it was already that way. Furthermore, we wouldn’t be dealing with all of this if we had just gone to universal health care. It may not be perfect, but it’s a lot better than where we are, as well as where we’ve been.

          • March 25, 2014 at 7:04 pm
            bob says:
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            Shirley,

            Outlawing private insurance would never be a step forward.

            Universal Insurance is only universal if there is private and public.

            If you want to put forth a “at least it would be better than where we are” scenario, then private and public is the way to go. Not to outlaw one.

            Universal is a pretty word, except for that it is a lie when worded that way if you remove the private option. It becomes “Sole Insurance” and that will never be a good option.

        • March 19, 2014 at 2:35 pm
          FFA says:
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          Libby, I would not want the same network if I move to WI. What I am dead set against is some yahoo in a call center or some joker navigator setting me up with someone I have no interest in seeing. My wife had to change some of her docs and is not happy with it. My choices were limited. 1) Pay more then I was on a max rated group to keep the same docs 2) Change networks / docs and get the premium I am at.
          My wife was a victim of his lie and she dont like it. Safe to say she hates all liars.
          She is a chronic non voter and will be out voting this time against the lies Obama and company (party) told everyone.
          Additionally, she sees how tight money is because of the Democrats (Fed & State) lies, well, she is moved to action.

          Sad state, vote for the one who we know lies the least.

          • March 19, 2014 at 3:18 pm
            FFA says:
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            Ron, I agree with you.

            Every time Govt at any level sticks their nose in pvt industry no matter the industry, average Joe gets screwed.

            Workers Comp reform? Health Care Reform? No Tort Reform, NO REFORM. Bunch of self serving jack asses.

            Il made the move from the good ole boys yesterday. Brady out. Dillard out. Rutherford out.

            Hello Bruce Rauner. Never served public office. Successful Business man. Financed his own campaign. Billionaire 1% er. Self Made man. You could tell in his speech he is not a politician, he is a business man with an eye on the bottom line. He even spoke out against raising the Min Wage and still won the nomination. Maybe Il has found their Scott Walker.

            Quinns speech? Babbling Buffoon. Pay attention Chicago – Dems have ruined this state. If you vote Dem in this state, you are voting for another 90000 jobs to leave this state.

          • March 19, 2014 at 3:48 pm
            Ron says:
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            Unfortunately, until we have term limits, I am not sure how effective someone like Mr. Rauner will be against the careers (Hunger Games reference). I do wish him the best, should he win.

            We definitely need to get away from the career politicians. Public service is supposed to be just that, not a career. That is why I am voting against all incumbents in every election in the near future. It will take someone very special to get a re-election vote from me. Even at that, it will only be one re-election vote. This is the only way we will see anything close to term limits. I hope the Agents of the world can get themselves to vote for a Democrat just send a message, but probably not.

          • March 19, 2014 at 4:08 pm
            Libby says:
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            FFA – no-one forced you to take the cheaper insurance. That was your choice and the pay-off was to change doctors. I’m sure there is more than one doctor in your network. Keep looking until you find one you like. I don’t understand the big deal with changing doctors, unless you’ve got one doing stuff they shouldn’t be doing and you know you won’t find another one that will.

          • March 19, 2014 at 4:58 pm
            FFA says:
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            Ron, Term Limits is one of Rauners promises. He had no support from the party. He paid for it all by himself. All three losers were whining about the finances.

            Libby, through this entire ACA fiasco, my limited market research tells me that women dont want to change doctors and men could care less who they have asking them to turn their head and cough. Women get picky with their legs in the stirrups.

            Women want limited access when men want unlimited access… IF – IF – IF and IF you dont care who sees / probes your “WHO WHO”, then you would be likely to change docs at any time. Again, my limited market research, men just dont care who sees the one eyed snake.

          • March 20, 2014 at 8:46 am
            Libby says:
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            FFA – Considering I only have to have someone look at and probe my hoo-hoo once a year, I really don’t care who it is. I just prefer a woman. It actually makes it easier if it’s a complete stranger. I don’t want to have a relationship with anyone about my hoo-hoo other than my husband.

            I see my PCP alot more than my gyno. And again, I don’t care as long as they know what they’re doing.

          • March 20, 2014 at 10:24 am
            FFA says:
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            Well Libby, you would be the exception to the rule. every woman I spoke with in regards to the lady parts doc, there is no way they are changing that doc.

          • March 20, 2014 at 10:30 am
            Libby says:
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            FFA,

            You should know by now that I am not your aver-age bear!

  • March 19, 2014 at 10:20 am
    FFA says:
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    Here is a question—
    How many people in local agencies lost their job due to decreased revenue to the agency?

    How many local agencies folded completely due to lost revenue?

    I know several that are struggling.

    • March 19, 2014 at 10:37 am
      Whodathunkit? says:
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      Our commissions per individual plans are down, but our volume of plans written has almost doubled. It does take about 50% longer to go through the process with people who qualify for a subsidy however.

      • March 19, 2014 at 3:19 pm
        FFA says:
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        Not worth the time.

  • March 19, 2014 at 10:23 am
    Destro says:
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    So 5 million people equates to 5% of the US population? Someone either doesn’t know how many people live in the US or has a very poor concept of basic mathematics.

  • March 19, 2014 at 11:04 am
    Ron says:
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    To anyone calling for health insurance companies to sell across state lines as a way to increase competition and lower costs:

    Are you advocating for national insurance regulation? That is not a sarcastic question, I am serious.

    No one has shown that the government is preventing health insurance companies from selling across state lines any differently than P&C.

    • March 19, 2014 at 1:08 pm
      Agent says:
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      Ron, I am surprised you didn’t go to your vaunted websites for answers to your questions instead of trying to pry it out of commenters on this site. No one has access to all information from the various states. Blue Cross has a number of state associations and plans can vary by state. One thing that doesn’t vary under Obamacare is that everyone has to take the mandated plans no matter where they are. The only thing that might vary are the rates, networks available. In many states, the doctor/hospital networks have been shown to not offer as extensive a list as before. In P&C, as long as companies are licensed in the state the customer is moving to, they will gladly take a customer who is with the company already and generally treat them well since they are in the system already. I had a customer move to Santa Fe, New Mexico. The company recommended an agent in that area to rewrite New Mexico coverage for the customer. It was pretty seamless and they got to keep the carrier they liked. It may not work for everyone, but it works for the majority.

      • March 19, 2014 at 1:50 pm
        Libby says:
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        I don’t see any difference between P&C and health in this regard. If you move, the carrier may or may not continue your coverage. You will be subject to rewrite, re-underwriting, new rates, and possibly a difference policy form.

        So WHAT is the difference? If you don’t know, just say so.

        • March 19, 2014 at 4:07 pm
          FFA says:
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          Only difference I can see is the state regulating it vs the Fed. Fed would be out of touch with regional issues and the state would be better suited for the regional issues.

          Fed tells bigger lies. State just takes our money.

          • March 19, 2014 at 4:11 pm
            Libby says:
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            The Feds don’t control insurance. It’s still state by state, P&C and HC. That’s what Ron and I are asking about. When people say Health carriers should be able to sell across state lines, what is stopping them that is not stopping P&C carriers?

            We need a benefits expert to explain. Are there any out there??

          • March 19, 2014 at 5:37 pm
            FFA says:
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            I dont understand the concept either. Why would it be less expensive to market across the US vs state by state?

            What research has been done to prove or dis prove any price differences?

            In my life time, any time the feds get involved, cost goes up.

          • March 20, 2014 at 8:47 am
            Libby says:
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            I agree, but it’s the carriers/brokers that want to sell across state lines.

      • March 19, 2014 at 1:54 pm
        Ron says:
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        Agent,

        Why must you make everything so difficult and personal.

        Everybody is talking about moving from one state to another, but not answering my question. It is a simple yes or no question, are health insurance companies allowed to write policies in multiple states? Either than can or they cannot. If they can and you want to advocate a way to improve the system, then go ahead. But all of the information I have seen indicates that they already are able to sell across state lines similar to P&C.

        Did the government force BCBS to form the different state associations or was that their business decision? If you do not know, please do not speculate.

        You said, “In P&C, as long as companies are licensed in the state the customer is moving to, they will gladly take a customer who is with the company already and generally treat them well since they are in the system already.” Everybody on this blog already knows that. Unless the company no longer wants the risk for some reason. Did you know that the company can cancel the policy in the new state for any reason because, from a regulatory standpoint, it is considered new business?

        Is that not the case with health insurance companies? I am trying to discover what is the difference.

        • March 19, 2014 at 2:08 pm
          KY jw says:
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          Ron, I don’t think anyone actually knows the answer. It’s a good question, though. If you move for work, your employer probably has arranged for your insurance to move with you. It seems to me, you HAVE to change doctors if you move to a new state. Well, if your new state is not within commuting distance of your old network. What else would change if move?

          If you purchase insurance outside of work, then your network would probably still change if your preferred company even writes in your new home. Since this happens in P&C (not every personal lines carrier operates in every state), I don’t understand what the difference is, either.

          • March 19, 2014 at 2:34 pm
            Ron says:
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            Thank you KY jw.

            It was meant to be a simple question, but got blown way out of proportion because nobody was answering my actual question. No where did I mention anything about moving from state-to-state. I just wanted to know how allowing health insurance companies to sell across state lines would increase competition and lower rates when it seems like they already can. Yes, they are regulated state-by-state, but so is P&C.

            Therefore, the only logical conclusion I could come up with is that those advocating to allow them to sell across state lines want health insurance regulated on a federal level to make it easier to sell across state lines. If that is not what they want, then what do they want?

            Federal regulation of insurance on any level is something to which I am vehemently opposed.

          • March 19, 2014 at 3:21 pm
            FFA says:
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            Moving out of IL, your premium would be substantially cheaper.

      • March 19, 2014 at 1:57 pm
        Ron says:
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        Agent,

        You complain when I go to websites for information, then complain when I do not and actually ask real insurance professionals.

        WHAT IS YOUR PROBLEM????????????

        • March 19, 2014 at 4:45 pm
          Libby says:
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          Ron,

          I found this that helps explain it.

          http://www.insureme.com/health-insurance/selling-insurance-across-state-lines

          • March 20, 2014 at 8:51 am
            Ron says:
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            Thank you Libby.

            It appears that the term selling across state lines in not an accurate description of whta is requested. It looks like they want to make it easier for health insurance companies to sell in multiple stqates wiothout need to adhere to each state’s regulations. In addition, it looks like the PPACA has addressed this to some extent with the establishment of state compacts. So, another right wing idea in the law.

            There are only 2 ways that this could work; 1. Federal regulation of health insurance, or 2. Getting all of the states to agree on some minimum regulatory standard. Unfortunately, one will cause more problems (federal regulation) and the other is highly unrealistic.

          • March 20, 2014 at 10:51 am
            KY jw says:
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            I don’t have anything to do with the health people, but I have NO doubt we will never see all the states agree on health regulations.

            Right now, ERISA keeps the state gov’t out of the health regulation for the majority of insureds. (didn’t someone say employment sponsored health ins is over 80% of insureds?)

            The only policies regulated by the state are individual policies. So, in actuality, we already have health insurance sold across state lines.

  • March 19, 2014 at 5:03 pm
    FFA says:
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    “Libby says:
    FFA – no-one forced you to take the cheaper insurance.”

    My budget forced me to take what I did. I am living proof that oBamas definition of affordable is not the same as my definition. Or the name of the law is just a lie or some sort of play on words.

    My Gr Children play the opposite game. Is that what OBama did here?

    It should be called the Screw Every Tax Payer Act. That would be accurate by my old school dictionary.



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