People enrolled in Blue Cross Blue Shield health insurance plans since the passage of health care reform have higher rates of disease and need “significantly more medical care” than policyholders in earlier years, according to a new report.
The findings from the Blue Cross Blue Shield Association raise concerns that Americans may face steep rate hikes in their insurance plans next year, reports CNN Money. In addition, some insurers may consider leaving the new insurance exchanges altogether.
The study found that policyholders enrolled in individual plans since passage of the Affordable Care Act — also called Obamacare — are more likely to be sick than people enrolled in employer-based BCBS individual health insurance plans prior to 2014.
The report notes that the ACA now guarantees coverage to people with pre-existing conditions and broadens benefits available to everyone.
Diseases that are more prevalent among the newer policyholders include:
- Coronary artery disease
- Human immunodeficiency virus (HIV)
- Hepatitis C
In addition, policyholders who newly enrolled in individual BCBS health plans in 2014 and 2015 received “significantly more medical care” on average than both:
- People enrolled in BCBS individual plans prior to 2014 who maintained BCBS individual health coverage into 2015.
- People with BCBS employer-based group health insurance.
New enrollees used more medical services in all types of care, including:
- Inpatient admissions
- Outpatient visits
- Medical professional services
- Prescriptions filled
- Emergency room visits
Medical costs for people newly enrolled in individual plans were an average 19 percent higher than employer-based group members in 2014, and 22 percent higher in 2015.
BCBS says its companies across the country have participated in the new health insurance marketplaces more broadly than any other insurance carrier, according to a company press release.
In the press release, Alissa Fox — senior vice president of the office of policy and representation for the BCBSA — says the findings highlight the need for people in the health care system to work with newly insured consumers to ensure patients “get the right health care service in the right care setting and at the right time.” She adds:
“Better communication and coordination is needed so that everyone understands how to avoid unnecessary emergency room visits, make full use of primary care and preventive services and learn how to properly adhere to their medications.”
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