Insurers Seek to Pull Out of Rural Counties in 2018

State officials say they hope to convince some health insurance companies to return – especially to Douglas, Lane, Lincoln and Tillamook counties, where Providence is the only company offering individual plans on marketplace exchanges next year.

Rural Oregonians will have fewer health insurance options than ever in 2018, unless state officials are able to lure back companies that have opted to leave many small regions behind.

In Douglas, Lane, Lincoln and Tillamook counties, Providence is the only insurer that plans to offer plans to individuals buying coverage on the marketplace exchange, where plans must be purchased for those hoping to qualify for subsidies or tax credits to help pay for care. Providence is the only insurer offering to sell both marketplace and off-exchange health plans to Oregonians in every county in the state.

Health Net, which is not participating in the marketplace exchange, is the only other insurer that has put forth plans to offer individual coverage in every county – but those plans are not eligible for tax credits.

“One important caveat: this likely will change,” said Lisa Morawski, spokeswoman for the Department of Consumer and Business Services, which includes the Oregon Insurance Division.

“We are still working with carriers to get them to come back to some counties,” Morawski told The Lund Report in an email.

“The level of choice available is an important issue for us, and something we have been watching closely for the past couple years,” she said. “Last year, we were able to get some carriers to add back counties after they filed rates. This year, we feel like we are in a better position, but are working on increasing options for four counties where there is only one choice on the marketplace for 2018.”

The most noteworthy change is Bridgespan’s decision to pull out of nearly all exchange marketplaces, except in the Portland metro area, after previously offering plans on the exchange in every county in Oregon. Cambia-owned Bridgespan is will still offer marketplace plans in Clackamas, Multnomah and Washington Counties.

It is completely leaving 18 counties: Douglas, Lane, Lincoln, Tillamook, Benton, Clatsop, Coos, Curry, Jackson, Josephine, Klamath, Lake, Linn, Columbia, Deschutes, Marion, Polk and Yamill. Bridgespan will continue to offer non-marketplace plans in Baker, Gilliam, Grant, Harney, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa, Wasco, Wheeler, Crook, Hood River and Jefferson counties.

Regence BlueCross BlueShield of Oregon, a Bridgespan sister company also owned by Cambia, is also pulling out of many rural counties – though even in 2017, Regence has only been available off the marketplace. It intends to offer coverage in the same communities where Bridgespan remains, according to filings with the state Insurance Division.

Many Regence BlueCross BlueShield customers have received letters saying their insurer plans to completely stop offering coverage in 2018 because of the uncertainty of national health policy. The Portland Business Journal reports that Cambia is instead developing new regional plans that would limit participants to providers associated with Oregon Health & Science University, Adventist Health and Tuality Healthcare – which all operate primarily in the greater Portland area.

At the same time as choices shrink for individuals buying health coverage, prices are also climbing – though not as much as insurance companies had hoped. The seven insurers that offer Affordable Care Act compliant plans in Oregon had asked for rate hikes ranging from 7 percent to 21 percent. Preliminary decisions by the Department of Consumer and Business Services hold those increases down, in most cases.

Here’s what a 40-year-old in the Portland area would pay each month of 2018 for a silver-rated plan under the preliminary decisions made by state regulators:

  • Kaiser Permanente: $355, up 14.8 percent
  • Providence Health Plan: $373, up 8.6 percent
  • Regence BlueCross BlueShield: $404, up 2.4 percent.
  • BridgeSpan: $396, down 1.6 percent from this year.
  • Moda Health Plan: $404, up 4.7 percent.
  • Health Net: $413, up 5.5 percent from this year.
  • PacificSource Health Plans: $452, up 2.8 percent.

The state Department of Financial Regulation is continuing to review and hold public hearings on these preliminary rate decisions, and will announce final rates on July 20.

Reach Courtney Sherwood at

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