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Wellmark responsible for low enrollment numbers in two states

Insurer dominates Iowa and South Dakota individual marketplaces
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When it comes to Affordable Care Act (ACA) enrollment success from this past year, Iowa and South Dakota sit on the very bottom of the list. In both states, only 11.1 percent of enrollees who qualified for subsidized coverage signed up, according to recent data from the Kaiser Family Foundation.

The root of the problem may stem from the fact that one insurer dominates both states' individual insurance marketplaces--Wellmark Blue Cross and Blue Shield, reports Kaiser Health News.

During the first open enrollment period, Wellmark chose to not sell on the ACA exchanges, preventing its consumers from buying subsized plans from the company, according to KHN.

"The primary reason, we didn't feel we were going to be able to guarantee the quality of experience [customers] are accustomed to with us," Wellmark Blue CEO John Forsyth told the Associated Press, FierceHealthPayer previously reported. "We didn't think the first few months would be very smooth."

But as the second enrollment period sets to open in November, once again, Wellmark will stay out of the Iowa and South Dakota exchanges, notes KHN.

If Wellmark were to sell on the exchange, enrollment in Iowa and South Dakota would both increase and provide coverage to residents eligible for financial assistance, notes the article.

So what does this mean for other insurers in these states?

CoOpportunity Health, a non-profit and consumer-owned insurer, states that because Wellmark decided to not join the exchange, it proposed a 14.3 percent premium increase for 2015, which is double what it would have proposed had Wellmark sold on the exchange, reports KHN.

In comparison, CoOpportunity, which also operates in Nebraska, proposed an increase in premiums of 10.7 percent, Human Events recently reported.

For more:
- here's the KHN story
- check out the Human Events piece
- here's the KFF data

Related Articles:
Wellmark opts out of Iowa exchange, citing customer service concerns
Affordable Care Act grandfathering driving costs up, Blues say
Wellmark pledges not to raise rates in 2014