Post #4117 by AdrianC on the Macroeconomic Trends & Risks board

Personal Finance / Macroeconomic Trends & Risks

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https://www.healthinsurance.org/blog/health-insure...

Why are carriers pulling out of the Marketplace?

Industry groups and insurers have described the current environment as a “perfect storm” for the individual market.

We got a letter from ours - Caresource - they are pulling out. That’s a problem for us. They were the only one with all our doctors. Hopefully we can retain a doctor or two when we have to switch providers for 2027…assuming there is a provider.

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My insurer is regional (most of MN and parts of WI/IA/NE?) and highly concentrated in the metro Twin Cities area (high population density AND high health care delivery capability). If you have a lot of *independent* doctors in their own practices, that can be a problem for you because the insurer can claim they have *enough* of doctors in specialty care X and don't need more (so yours may not be included). My doctors are in large practice groups, with many care locations, that are almost always included in most health care programs. A few insurers do not include one or the other of these large groups--but omitting BOTH groups would mean the insurer is targeting a client market that wouldn't use them as providers anyway.

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If you have a lot of *independent* doctors in their own practices, that can be a problem for you...

Yes. We looked and it's only my PCP that's independent. All others are large group. I can switch PCP. I do like the NP I usually see, but whatever.

We really want to keep our specialists. Main concern is if we will be able to buy insurance at all.

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