If you reside in Tennessee, there’s a likely chance that next year you may be without options within the federally facilitated healthcare exchange under the Affordable Care Act (ACA). This news arrives on the heels of healthcare giants like Humana exiting the ACA exchanges and leaving large gaps in coverage in states like Tennessee. We can point to Knoxville, Tennessee, where 40,000 of its residents will lose their healthcare. This is the kind of predicament that has the GOP up in arms—quickly to point out the flaws in the ACA. However, is the state itself contributing to the problem?
States like Tennessee allow for certain underwritten plans that are not compliant with the ACA. These plans can’t be offered within the ACA exchange and do not bypass the individual healthcare tax penalty. Tennessee has its own association known as the Tennessee Farm Bureau, which provides these non-compliant plans at lower costs than ACA exchange offerings. However, pre-existing condition screenings may be a requirement. Still, this poses a huge threat for Tennessee and its future with the ACA exchange.
For one, healthier people may enroll in these underwritten plans within the Tennessee Farm Bureau; although not necessarily comparing apples to apples, they’re arguably less expensive than the ACA compliant plans. For someone categorically healthy, they could slide right along with eligibility and have just enough coverage for everyday life with one of these non-ACA plans and pay the individual penalty.
Who does that leave? Unhealthy people, not qualified for these Tennessee Farm Bureau plans, seeking ACA exchange options and leaving a larger high risk pool to be covered by those plans on the ACA exchange. While there remains a need for providers to re-enter Tennessee’s ACA exchange and offer coverage for all parts of the state, in places with these aforementioned risk pools, they may be more reluctant to do so.
TN Republican Senator Lamar Alexander seeks to help the situation in the form of a bill that will hopefully provide relief to some of these regions in Tennessee with no ACA exchange options by eliminating the individual penalty for those with no options for health insurance on the ACA exchange, but will they only make the larger problem with healthcare worse?
