Study: Blue Cross Blue Shield Dominates Half of Obamacare Enrollment

Blue Cross Blue Cross dominates nearly half of all Obamacare enrollment, according to a study released by the Urban Institute.

The Urban Institute collected data from the Obamacare state marketplaces and found that Blue Cross Blue Shield plans control 47 percent, nearly half, of all marketplace plans in 2018 through plans owned, operated, or affiliated with the health insurance conglomerate.

“Blue Cross Blue Shield-affiliated insurers hold all or close to all of the enrollment in 11 states’ marketplaces,” the Urban Institute wrote. The think tank wrote that Blue Cross Blue Shield network dominates Alaska, Alabama, Delaware, Illinois, Louisiana, North Carolina, North Dakota, New Hampshire, Oklahoma, South Carolina, and Wyoming.

In nine other states — Arkansas, Florida, Hawaii, Kansas, Michigan, New Jersey, Pennsylvania, Tennessee, and West Virginia — “Blue Cross Blue Shield plans have the majority of enrollment, though they face increasing competition from other insurer types, typically Medicaid insurers,” the institute noted.

Even though Blue Cross Blue Shield controls much of the Obamacare marketplace, many large health insurers have planned to increase competition in the Affordable Care Act (ACA) marketplaces. UnitedHealth Group’s UnitedHealthcare plans to reenter new individual insurance markets in 2021.

Centene, Molina Healthcare, and UnitedHealthcare have started seeing their Medicaid divisions grow as Americans lose their employer-based health insurance and become eligible for Obamacare plans or Medicaid benefits.

Katherine Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation, which funded the Urban Institute study, noted that the “employer market is shrinking, and carriers will want to follow their members to the marketplace and Medicaid.”

She continued:

This suggests there will be more entry into an increasingly competitive marketplace. Carriers may feel they will be most successful in markets where they are already participating in Medicaid, as suggested by (UnitedHealth Group’s) recent moves in Maryland and Washington. Those with little Medicaid footprint may find it harder to be competitive.

UnitedHealth said that they plan to expand their products in the coming years.

“As the exchanges have matured and stabilized, we intend to offer exchange plans in those states where we can provide an efficient network and competitive product capable of driving sustainable value for consumers and our state and federal partners,” a UnitedHealth Group spokesperson said.

“We believe an exchange product, where sustainable, can complement our existing portfolio of public and private options which are capable of providing universal coverage to all Americans,” the spokesperson added.