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Excellus customers react to dropped Medicaid coverage

Rochester, N.Y. On Wednesday, Excellus BlueCross BlueShield announced its Medicaid and Family Health Plus programs will be dropped. Excellus has submitted paperwork with the New York Department of Health to withdraw from these government health insurance programs.

According to spokesperson Jim Redmond, the programs will end February 1 for Livingston, Ontario and Wayne counties and March 1 for Monroe and Orleans counties. 

In a statement, the company said: 

The health plan is incurring losses approaching $100 million on these products in 2013 and we expect that amount to increase in 2014. Losses of this magnitude are simply unsustainable. 

Richard, an Irondequoit resident with Excellus Medicaid, said he is angry at the providers decision to drop these programs. Hes especially upset at the fact that he didnt hear from Excellus themselves about the decision. 

I didn't get no letter or nothing and I find out on the news that I'm getting thrown under the bus? he asked.

Richard went on Excellus Medicaid plan after his divorce a few years ago. He says this coverage is vital.

I'm on several different types of medications I need to take and my co-pay is only a dollar, he explained. [Until recently] I had no income. No income. I've been living off of savings all this time. 

Between Monroe, Ontario, Wayne, Livingston, Orleans and Wayne counties there are about 105,000 people who are enrolled in either program.

A few years ago, New York state changed the reimbursement structure for the Medicaid program and Excellus cites this as the reason why they have had bear more financial burdens. 

The healthcare community is already raising concerns. 

We are very worried about this issue of Excellus getting out of the Medicaid managed care program because they are an excellent partner with everything we do and they run a very good program, said Fran Weisberg, the executive director of the Finger Lakes Health Systems Agency. 

Weisberg believes that these changes could cause problems. 

There are thousands and thousands of people who are on this program and then if Excellus were to get out of the programs because they can no longer run it would be disruptive to the people, Weisberg explained. They would have to find a new plan to cover them and there is just myriad kinds of services that now exist under this plan and it's a very good plan and now thousands of people will say, Now what do I do?. 

Nancy Adams, the executive director of the Monroe County Medical Society, agrees. She believes there will issue with access to care with these changes. 

Unless something changes, we expect that Excellus would notify you to tell you when the plan will end, Adams said. They need to work out a transition plan with New York State so there will be other carriers that may take you on. Make sure or try to find out does your physician actually accept the other insurance? In Rochester, virtually every physician accepts Excellus and MVP however; other plans that may come into the market may not be accepted. 

Richard says this is a concern for him as well. He doesnt want to change doctors. 

My doctor is very important to me, he said. Its very important indeed. I've been going to her for some time and she knows me. We get a long very well. 

In 2012, Excellus BlueCross BlueShield made $106 million in profit, less than half of the profit made in 2011. 

Weisberg says FLHSA will want to reach out to Excellus and state leaders to see if something could be done to prevent Excellus from dropping Medicaid and Family Health Plus. 

However, Redmond said theyve tried. 

We have had several meetings with the State throughout 2013 to see if the losses could be addressed by changes in reimbursements that the State pays us to provide coverage. We value the State as a partner but we have been informed that changes that would meaningfully reduce these losses are not forthcoming. 

The changes do not affect Excellus Medicare or Child Health Plus programs. 

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Washington Times