North Carolina will have a significantly different ACA experience next year. A new insurer, Centene, is entering a few counties in the Triangle region. The Triangle will have three insurers: BCBS-NC, Cigna and Centene. The rest of the state will still be a BCBS-NC monopoly. BCBS-NC’s average premium is decreasing.
We reached an agreement with @UNC_Health_Care Alliance to lower individual #ACA rates in the Greater Triangle Region by more than 21% before subsidies. Benefits are staying similar. Learn how this deal could change health care for all. https://t.co/tf7YLKplRz pic.twitter.com/3bIBA8kvfD
— Blue Cross NC (@BlueCrossNC) August 22, 2018
Pricing is collapsing in the regions where there are multiple hospital chains. BCBS-NC is aggressively going to a narrow network strategy in these regions with shared risk with the contracted hospital/provider groups. The rest of the state is seeing modest premium increases.
This continue current trends for the lived experience of the subsidized buyers in North Carolina as long as we assume near uniform percentage changes by metal band in each region.
In regions where prices are decreasing, the Silver Spreads between the least expensive Silver plan and the benchmark Silver plan will compress. Plans that are less expensive than the Benchmark (assuming uniform percentage changes in premiums) will become relatively more expensive in 2019 than they were in 2018 for subsidized buyers.
Subsidized buyers in Raleigh and Durham will have more choices but will probably be paying more for their plans. Unsubisidized buyers in these two cities along with their surrounding counties will have more choices including at least some that are at a lower premium in 2019 than they had in 2018. Unsubsidized buyers in Metro Charlotte will see lower premiums while subsidized buyers in Metro Charlotte should anticipate seeing slightly higher premiums for anything other than the benchmark Silver.
The rest of the state will see the inverse. Subsidized buyers will see better deals on plans that cost less than the Benchmark. They’ll pay a bit more for plans (including Gold) that cost more than the Benchmark. Unsubsidized buyers will get kicked again with another premium increase.
2018 Silver Gap maps are underneath the fold