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Highmark Health Shifts to Narrow Network Plans Due to ObamaCare Costs September 8, 2015

Galen Institute, September 8, 2015

According to a Sept. 3 report by Anna Wilde Mathews of the Wall Street Journal, Pittsburgh-based Highmark Health announced it will cut back its range of plans offered through the ObamaCare marketplaces. The nonprofit company currently covers around 380,000 marketplace enrollees in Pennsylvania, Delaware, and West Virginia. During the first six months of 2015, Highmark recorded a loss of $318 million on individual health plans due to a heavy influx of high-risk patients into the exchanges. Patients with chronic conditions such as diabetes and congestive heart failure were drawn to the broad provider networks and consumed more care than expected. Compared to a loss of $76 million the first six months of 2014, costs have continued to dramatically rise with no sign of stabilizing. As a result, Highmark will shift toward options with narrower provider networks. This is just one way the insurance industry is mitigating the high costs of ObamaCare plans; Highmark is among the many companies that has proposed double-digit rate increases this year.