Regence BlueShield, one of the state's largest health insurers, will no longer offer child-only individual plans, a move that state insurance officials fear may trigger other insurers to drop similar policies.
Regence BlueShield, one of the state’s largest health insurers, will no longer offer child-only individual plans, a move that state insurance officials fear may trigger other insurers to drop similar policies.
The Regence decision comes as regulations contained in the new federal health-care overhaul prohibit insurers from refusing coverage to children with pre-existing medical conditions.
Regence, in a statement, said the move affects only new policies and it is not dropping the 2,500 children it now insures under such policies.
Another large insurer, Premera Blue Cross, with about 1,400 child-only policies in the state, said in a statement it would continue selling such policies “for now” and wanted to continue to do so.
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“However, given the new law, it’s important that all major carriers share the risk and costs. We will continue to monitor the situation given the recent announcement by another major carrier in Washington,” the statement said, referring to Regence, the state’s largest child-only insurer.
Regence’s decision, effective Oct. 1, comes after days of discussions with insurance regulators, said Insurance Commissioner Mike Kreidler, who said his office tried to make regulatory concessions and strongly objects to Regence’s “precipitous action.”
“The bad guy here is Regence,” Kreidler said. “It didn’t have to take this action.”
Kreidler’s office adopted an emergency rule last week that would have allowed health insurers to screen children for pre-existing conditions during enrollment most of the year, while also allowing parents to insure children without any screening if they signed up during a special enrollment period from Nov. 1 to Dec. 15.
The rule was intended to balance the needs of parents with the need to keep insurers in the marketplace by making it more difficult for parents to insure kids only when they need health services. That can cause a spiral of increasing costs and rising premiums, with the effect that only the sick enroll.
But federal regulators put the kibosh on Kreidler’s plan, saying they didn’t have the flexibility to allow insurers to screen kids at any time during the year. They said if a company offered child-only policies, it had to take all kids, all the time.
Many insurers across the country have reacted to the new federal regulations by dropping such policies. Major health insurers in other states began dropping the policies early this summer, in advance of the mandate, which took effect Sept. 23.
But Kreidler said Washington state is somewhat different, in that individual policies often are sold to the whole family, including children. Those who buy child-only policies might be people who can’t afford full-family coverage, or those workers whose employers don’t offer dependent coverage, forcing them to buy child-only coverage.
Kreidler said the open-enrollment period instated last week by his office was intended to keep Regence and other carriers “in the market” offering child-only policies.
Even considering federal regulators’ inflexibility on the new rules, Kreidler said he believes the open enrollment period would limit insurers’ risk. He wanted Regence to wait and see how the federal regulations and open enrollment period would play out before deciding whether to stop selling policies.
“Their overreaction will seriously harm Washington families,” Kreidler said.
Regence, in a statement, said the company has covered children for 93 years and will continue to do so. “Our experience tells us the right thing to do is provide coverage to the entire family, not just children.”
Carol M. Ostrom: 206-464-2249 or firstname.lastname@example.org