Arizona health insurance marketplace: history and
news of the state’s exchange

BCBS of Arizona and Bright Health offering plans for 2018; cost of CSR added to silver premiums,making other
metal levels particularly affordable

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Louise Norris
Individual health insurance and health reform authority; broker
March 22, 2018

More Arizona coverage

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    Insurance Guide
    • A guide to health insurance in
      your state.
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    • Your state’s Medicaid expansion,
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    • Insurance for those over 64

Highlights and updates

  • 2018 enrollment down 4.6% from 2017
  • One insurer in 2017, but Bright Health joined in 2018
  • Average rate increase 15.6%, including added premiums to cover CSR cost
  • Cost of CSR added to silver exchange, other metal levels particularly cheap for some
  • 2018 rates and new insurer indicate death spiral no longer a danger

Arizona exchange overview

In 2018, Arizona had one of the smallest rate increases across the country at 57% coming in behind only Oklahoma. However, though their rate increase was among the smallest, their premiums are among the largest and they increased an average of 116%.

This is due to the decrease of carriers in 2017. In 2015, there were 11 carriers offering plans in Arizona and that number has dwindled to only two in 2017 (Blue Cross Blue Shield and Centene/Ambetter from Health Net). Both of these companies are in the exchange for 2018 but with smaller rate increases than they had in 2017. Blue Cross Blue Shield approved an average rate increase of 51% in 2017 but had a surprising decrease of .9% for 2018. Centene/Ambetter from Health Net approved an average rate increase of 74.5% in 2017 but only a 1.8% increase for 2018.

In Arizona, coverage with each health insurance provider is localized. In 2017, every county in the state had only two providers except for Pima County—they only had one. Blue Cross Blue Shield had cancelled their catastrophic plan in Pima County leaving the residents of that county with just one option.

Arizona and Medicaid

Medicaid in Arizona is called Arizona Health Care Cost Containment System or AHCCCS. In 2016, the Obama Administration CMS approved Arizona’s waiver proposal, which requires the state to get an annual waiver from CMS to permit additional restrictions. This new waiver will run through 2021 and it implemented a requirement for health savings account contributions from recipients about poverty level. They also opted for an optional job search program. The CMS, however, did not allow Arizona to implement a work requirement or charge premiums for recipients below poverty level. However, with the Trump Administration, they may implement a five-year limit on Medicaid coverage for able-bodied enrollees and a work requirement.

As Medicaid in Arizona continues to expand, 58% of uninsured nonelderly residents are eligible for health insurance coverage. Additionally, 42% of those uninsured are not eligible because of immigration states.

Arizona and Medicare

In the United States, 17% of the population is enrolled in Medicare. Arizona is slightly below that at 11% being enrolled in Medicare. Of those Medicare recipients, 86% qualify for Medicare due to age and the other 14% is due to a disability. If Arizona Medicare recipients want additional benefits, they can opt for the Medicare Advantage plan and 38% of recipients made that choice in 2016.

State Health Rankings

Arizona was ranked 32nd by the Scorecard on State Health System Performance in 2017 and the state ranked 35th on the number of people without health insurance and 45th for the number of adults with a regular medical home. Additionally, the state earned 37th for the number of people uninsured as well as access to primary care physicians.

Residents Enrolled In Health Plans

In 2017, 196,291 people had enrolled in private health coverage plans during open enrollment which was a decline from previous years. The reason for this decline is due to the skeptical future of the Affordable Care Act as well as the Trump Administration cutting back on marketing and outreach for As for 2018 open enrollment, only 165,758 people signed up which is a 15% decline.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.