- Associated Press - Friday, October 28, 2016

COLUMBIA, S.C. (AP) - South Carolinians who buy their health insurance through the federal online marketplace have fewer choices than ever, with just one insurer remaining in the program raising premiums an average of 28 percent.

BlueCross BlueShield is the only insurer offering 2017 policies in South Carolina through the exchange created by President Barack Obama’s health law. Even its HMO subsidiary, BlueChoice, is no longer in the exchange.

That means 114,000 people will have to change policies to stay insured, said state Department of Insurance Director Ray Farmer.

As for the higher premiums, it’s worth noting that 90 percent of the nearly 217,000 people covered by Healthcare.gov policies in South Carolina get federal subsidies that make premiums more affordable. That means that although BlueCross‘ plans are increasing between 14 percent and 31 percent, the rate hikes will be lower for people receiving subsidies.

Meanwhile, BlueCross and other insurers are making similar premium increases outside the marketplace, where customers don’t get the federal subsidies.

The 48 non-subsidized plans offered outside the market by BlueCross, its subsidiary BlueChoice, and four other companies writing individual policies in South Carolina, are increasing by 27 percent on average. Those changes range from an 8 percent decline to a 31 percent increase, according to the Department of Insurance.

The fourth year of sign-ups for private, taxpayer-subsidized coverage sold through HealthCare.gov begins next week.

Insurer choices in South Carolina had already dwindled since sign-ups began in fall 2013. Last year, while four insurers were participating in the exchange, only BlueCross BlueShield and BlueChoice were offering policies statewide. Only two counties had a choice of all four.

The two Blue companies accounted for more than 95 percent of the nearly 217,000 people covered through the exchange as of this summer, according to the Department of Insurance.

The two companies that exited the market last year included Consumers’ Choice, a cooperative the law created, which folded altogether, leaving 67,000 individuals and business customers looking for new coverage a year ago.

This time, the South Carolina customers of insurers leaving the federal exchange don’t have to pick a new plan to remain covered.

If they do nothing, the system will auto-enroll them in a BlueCross BlueShield plan deemed similar to what they have. They’ll get a packet of information on what’s been assigned and a bill, Farmer said.

“If they pay the bill, they’ll have the coverage,” he said.

Still, Farmer recommends shopping around. BlueCross is offering 26 different health plans through the federal marketplace, rated bronze, silver and gold for how much of the costs they cover. Generally, lower premiums mean higher out-of-pocket costs.

South Carolina is among five states with just one insurer participating statewide. The others are Alaska, Alabama, Oklahoma, and Wyoming. Another eight states - Arizona, Florida, Georgia, Missouri, Mississippi, North Carolina, Nevada and Tennessee - have only one participating insurer in a majority of their counties.

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