WORLD FUTURE FUND
THE CANCER CARE CRISIS IN VIRGINIA
Cancer is a matter of life and death. Anthem's decision to leave the individual health insurance market in Virginia — abandoning around 200,000 customers — is putting peoples' lives at risk. In the vacuum left by Anthem, Cigna is the only provider left in many parts of the state. Yet Cigna's individual plan, Cigna Connect, does not even offer access to Inova, which in many areas is the main hospital system and best option, or only option, for cancer care.
As one of the largest providers of health insurance in the nation, one would think Anthem would take its responsibility to the lives of its customers seriously. This is not the case. After the Republicans made repeated attempts to repeal the Affordable Care Act (ACA), the health insurance market was shaken by uncertainty. What made things even worse was President Donald Trump's promise to end cost sharing subsidies, and the shortening of the health insurance enrollment period to a mere six weeks. Anthem's response to this uncertainty was to pull out of several states around the nation, including Virginia. Their exit was so hasty, many customers never even received an official notification of their departure. Anthem also decided to leave before realizing they'd be abandoning some areas to no providers at all. They have since rescinded that decision and offer care in areas where they are the sole provider.
But they have still abandoned 200,000 customers when this wasn't necessary. Carefirst faced the same problems they did and chose to stay.
Anthem has had a history of recklessness and incompetence. In 2015, they allowed hackers to steal the personal information and patient IDs of 80 million of their customers. And they completely blundered their merger with Cigna.
Anthem's decision to pull out of the state of Virginia has severed severed cancer patients from their regular doctors. Many cancer patients can no longer even receive care at the main hospitals in their areas, or the Inova health system, which offers the top cancer care in the state.
A particularly distressing situation is that of 4-year-old cancer patient Colette Briggs. Her parents can no longer buy an Affordable Care Act plan to cover her hospital care. For half her young life, she has depended upon chemotherapy treatments to keep her alive. Yet now the health insurance plans available to the Briggs family on the individual marketplace do not cover Inova Fairfax Hospital where Colette receives spinal tap chemo and emergency care. For years, the Briggs family living in Loudoun County Virginia purchased insurance from Anthem, but this year this is no longer an option.
The only insurance company available to Colette's self-employed father is the Cigna Connect policy for individuals, but this policy does not cover Fairfax Hospital or the entire Inova health system. The Fairfax Hospital is the only local hospital with a dedicated pediatric cancer unit, a hospital where Colette has been a patient for more than two years.
According to Inova President and COO Mark Stauder, there is some hope that Cigna will add Inova to its list of in-network providers for the exchange plans. Inova and Cigna do have managed care agreements for other Cigna plans, but the hospital network “has not been offered” a contract for the exchange coverage.
“We have had conversations throughout the year,” Stauder said. “We’ve had many, many conversations.”
While those talks have failed to generate a deal, more meetings are planned, he said. And Stauder said input from Cigna’s customers or prospective customers could help advance the negotiations.
Cigna must now fill in the vacuum left by Anthem. They must offer plans on the individual health insurance market that will provide patients with service at the Inova hospital system. Peoples' lives are at stake.
CONTACT ANTHEM AND DEMAND THAT THEY RESTORE THEIR POLICIES
Anthem CEO Gail K. Boudreaux
Gail K. Boudreaux
CONTACT CIGNA AND DEMAND THAT THEY
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WORLD FUTURE FUND HEALTH CARE REPORTS