Blue Cross Blue Shield of Texas Deems Certain Plans “Unsustainable” Due to Losses Caused by Affordable Care Act

DontComply has discovered an internal email from Blue Cross and Blue Shield of Texas that was sent out to insurance agents on 07/23/2015. If you have a Blue Cross and Blue Shield plan in the state of Texas, this information affects you more than others. There is a big change coming down the pipeline from Blue Cross corporate for 2016 plans and you might already know which law is at fault. I’ll get to that after we go over the changes. Blue Cross Blue Shield of Texas is going to be discontinuing PPO health insurance plans for the 2016 plan year. At the time of writing, there are 367,000 members on the Blue Cross PPO plans who will have their plan discontinued in 2016. For those not aware, most insurance companies have typically offered PPO or HMO plan choices for a long time now… at least as far back as I can remember. HMO plans or “Health Maintenance Organization” Plans require that you choose one primary doctor. If you want to go anywhere else, you must first obtain a referral from the your PCP (Primary Care Physician). With a PPO plan, you can go to any doctor at any time that accepts the PPO network. PPO is the better option for most although it does come with a higher price-tag. If you have been on a PPO style plan and are forced to downgrade to something like an HMO, you will not be happy I can assure you. What reason does Blue Cross cite for their discontinuation of all these PPO plan options in Texas CLAIMS! What is a claim? Every time you go to the doctor, a claim is filed. Blue Cross Blue Shield has paid out over $400 Million in claims overwhat they took in as premiums. That was only in 2014. Blue Cross mentions that these losses are “unsustainable” and of course they are right. If I was losing $400 Million in one year I would look at it in a similar way. “The tendency of those in dangerous jobs or high risk lifestyles to get life insurance.” In the past this phrase would have meant much less due to underwriting. In the underwriting process, insurers had the choice to deny applicants based on health history. Now due to the “Affordable” Care Act, insurers have no choice but to accept every single applicant. Those who can’t afford the insurance are subsidized by the government (given money that is free to them to purchase insurance with). This sounds like a wonderful idea if you do not value free-markets or any kind of logical world where competition is allowed and encouraged. The “Affordable” Care Act is an attack on the current insurance industry and free trade. The majority of Blue Cross Blue Shield branches are considered non-profit but even they can’t keep a plan that looses $400 Million in one year. The multitude of promises from the leader of this nation, saying that you could “keep your doctor” and “keep your plan”, were exposed as lies from the start of this catastrophe. We are seeing even more ill effects from this “Care” Act as it was called so deceptively. It was understood that Americans would not jump at the prospect of socialized health care, so the plan appears to be more in line with the Trojan Horse. Attack and cause collapse/chaos from the inside. At every turn the government aligned with this ridiculous law are cornering the healthcare market until you have no choice but to choose the “better and improved” public plan option. They have already proved their reach with these unconstitutional tax penalties for the uninsured. Even further is the way that although Blue Cross is being forced to drop their PPO plans due to losses, they can’t promise that a new and similar plan will even fill it’s place. Why? They are waiting on approval from guess who? The government:

“We intend to offer other products, on and off the Marketplace. A new product has been filed that we believe will give you a flexible choice for your clients. We will be able to share information about that product if and when it is approved by the Centers for Medicare & Medicaid Services (CMS) closer to open enrollment.”

This law is a train-wreck and I suspect that this is only one of many issues we will see continue to arise. If you are on a PPO Plan from Blue Cross and Blue Shield, keep a close eye on this come October. October starts the yearly Open Enrollment period when the government ALLOWS you to switch plans. If you are not within the income levels that make you eligible for a subsidy, remember that you do NOT need to use the .gov website. You can apply directly through an insurer. Don’t give more information to their weakly secured site than is needed.