HJNO Mar/Apr 2026

DIALOGUE 10 MAR / APR 2026 I  HEALTHCARE JOURNAL OF NEW ORLEANS Editor Blue Cross Blue Shield of Louisiana represents a significant share of the state’s health insurance market. How would you characterize its current financial strength and market role, and does its dominance create risks or stability for Louisiana consumers? Temple Louisiana Blue is financially quite strong and stable. Its historical market dominance obviously presents certain challenges, but it also means that our state’s insurance market has been driven far more by local interests than states where large, national carriers predominate. Ultimately, however, the department reviews its rates and practices under the same standards as any other insurer. Stability and accountability must go hand in hand. Editor How concentrated is Louisiana’s overall health insurance market today, and is the current level of competition sufficient to protect consumers and employers? the commercial insurance market. Still, the fact that an unusually large proportion of our residents lack the resources to meet their medical needs means that commercial insurance shoulders an especially large share of the cost burden. Government- sponsored benefits typically underpay the cost of care, leaving commercial coverage to make up the gap. That puts an extraordinary pressure on insurance premiums in a state where nearly 3 in 5 residents are on either Medicare or Medicaid. Editor The enhanced ACA premium subsidies expired at the end of 2025. What immediate effects are you seeing in Louisiana’s individual insurance market? Temple We estimate that a little over half of the rate increase this year was driven by the expiration of the subsidies. This caused insurers to project a lot of their healthy insureds would drop coverage, leaving the remaining pool sicker, on average, than last year. That means the average enrollee costs more to cover this year than last, driving an increase in premiums. Editor Health insurance premiums vary significantly by ZIP code in Louisiana. What factors drive those geographic differences, and do you believe the current structure is fair to consumers? Temple Premiums vary by geographic rating area due to regional variations in cost of care, utilization patterns, and composition of the risk pool in that area. Louisiana’s eight rating areas were selected to group insureds based on common regional providers and costs. I believe it is fair because the overwhelming majority of states use similar geographic rating areas; variation based on actual costs prevents insureds in areas with access to cheaper care from being forced to subsidize high-cost areas; and forcing carriers to insure disparate risk at a single rate would encourage far worse behavior, such as carriers avoiding writing coverage in high-cost areas.