After the state's largest insurer announced it would stop selling independent coverage in the Nashville region, people who buy insurance out of pocket from BlueCross BlueShield of Tennessee are now trying to figure out what the next step is.
Mike Cooper, a muralist in Franklin, wasn't happy earlier this summer when he heard that BlueCross was raising its rates an average of 63 percent in Tennessee.
Cooper and his wife buy insurance out of pocket, and they make too much money to get a subsidy, so they have to pay the full sticker price. That was already almost unmanageable.
"We pay close to $1,500 a month," he said. "We pay more for health insurance than we do for our mortgage."
And then, this week, he learned BlueCross was not going to offer insurance in his area at all. So now he has two worries — finding a plan and paying for it.
He jokes that the stress will, ironically, send him to the doctor.
Even people who sell insurance are uncertain about the future. David Kardokus works for Full Service Insurance in Franklin, and he says he's been getting lots of questions from clients since BlueCross made the announcement.
He's still waiting to hear how the alternative plans stack up before making recommendations.
"Now the dominant carrier is no longer offering coverage, there are several factors we're going to have to look at to be able to find our customers good-quality insurance coverage," he said. "That coverage may or may not be cheaper."
The plans that Cigna and Humana offer in the Nashville region should be less expensive, on average, than Blue Cross's would have been, according to initial numbers from the state. But those rates, too, are increasing significantly.
BlueCross's departure affects about 71,500 people in Middle Tennessee who buy insurance out-of-pocket — either on or off the federal Marketplace. It does not affect employer-provided insurance or Medicaid.
The increased cost of individual insurance (even before BlueCross said it was leaving the region) is particularly felt by those who don't qualify for federal subsidies — that is, they make more than two-and-a-half times the poverty level.
For people who qualify for subsidies, the price change will not have a big effect on how much they ultimately pay.
According to the state, Cigna and Humana have committed to providing insurance in the Nashville region next year, both on and off the Marketplace.
Meanwhile, Aetna, Freedom National and TRH Health will provide insurance off the Marketplace early.
The open enrollment period to purchase new health insurance begins Nov. 1.