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Insurer’s demise raises concerns about Ohioans’ coverage

June 16, 2016

COLUMBUS, Ohio (AP) — Health care advocates and a U.S. senator are raising concerns that nearly 22,000 Ohioans could end up paying much more for health care as their struggling insurer winds down its operations.

Republican Sen. Rob Portman asked federal officials on Thursday whether InHealth Mutual policyholders will have to satisfy new insurance deductibles if they switch plans, though they may have already paid hundreds or thousands of dollars this year with the financially troubled carrier.

Portman also questioned whether some policyholders might face a federal tax penalty if they continue to stay on a plan that no longer meets certain minimum coverage requirements under the Affordable Care Act.

“In short, Ohioans who trusted in the Obamacare marketplace now find themselves between a regulatory rock and financial hardship,” Portman wrote to Andy Slavitt, head of the Centers for Medicare and Medicaid Services.

A spokesman for the federal agency said it would respond directly to the senator.

“We are working with InHealth and the state to provide consumers with the information they need to stay covered,” said Aaron Albright, a CMS spokesman.

The questions come after a judge last month allowed Ohio’s insurance department to take over the suburban Columbus-based Coordinated Health Mutual Inc., an insurance co-op that sold the policies under its InHealth brand. The court granted the state’s request to liquidate the company after a financial review showed the company’s losses would keep it from paying future claims.

Such insurance co-ops were created under President Barack Obama’s health care law to provide a nonprofit alternative to commercial insurers. But they struggled to build their businesses. Twelve have folded and regulators are winding down the Ohio co-op.

Tax credits end June 30 for consumers who bought InHealth coverage through the federal marketplace. They must pick a new plan before then to keep their subsidies for July. Those that don’t will have until July 26 to enroll into a new plan with tax credits.

Advocates and provider organizations want Ohio insurers who pick up InHealth members to apply any medical expenses already incurred toward their new deductibles and out-of-pocket maximums.

“It would be a terrible hardship for those newly enrolling in a plan through no fault of their own to begin paying all of their own medical expenses when they may have partially or fully met their deductibles,” the groups wrote in an open letter to insurers Thursday.

Those signing the letter were the Ohio Hospital Association, Ohio State Medical Association, Ohio Academy of Family Physicians, Ohio Association of Community Health Centers, Ohio Osteopathic Association and the Universal Health Care Action Network of Ohio.

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