Covered California Keeps Premiums Stable by Adding Cost-Sharing Reduction Surcharge Only to Silver Plans to Limit Consumer Impact
In the absence of a federal commitment to continue funding cost-sharing reduction (CSR) reimbursements through the upcoming year, Covered California health insurance companies will add a surcharge to Silver-tier products in 2018.
However, because the surcharge will only be applied to Silver-tier plans, nearly four out of five consumers will see their premiums stay the same or decrease, since the amount of financial help they receive will also rise. Those who do not get financial help will not have to pay a surcharge.
Financial help means that in 2018, nearly 60 percent of subsidy-eligible enrollees will have access to Silver coverage for less than $100 per month — the same as it was in 2017 — and 74 percent can purchase Bronze coverage for less than $10 per month.
California and individual markets across the nation still need a clear commitment that the federal government will continue to make CSR payments to promote lower premiums, save taxpayer money and ensure health insurance companies participate.
Note: This post is a joint effort with colleagues who have closely tracked the CSR chaos induced by Trump and Republicans in Congress. Dave Anderson is a former health insurance analyst, now a healthcare scholar at Duke, and a blogger at Balloon Juice; Louise Norris is co-owner with her husband Jay of a unique health insurance brokerage for individual market customers, and a top source of marketplace information and analysis at her own blog as well as at healthinsurance.org and elsewhere. Andrew Sprung writes about healthcare policy on his blog, xpostfactoid, as well as at healthinsurance.org and other publications.
In August I reported that the three individual market carriers in West Virginia (CareFirst, Highmark BCBS and Health Plan of the Upper Ohio Valley) were requesting average rate hikes of around 17.8% assuming CSR payments are made or 27.8% assuming they aren't.
The West Virginia Insurance Commission approved rate increases for Highmark West Virginia and CareSource Insurance’s services sold in the “Obamacare” exchange.
MetroNews learned Tuesday premiums for Highmark West Virginia will increase by 25.6 percent, while CareSource Insurance will have a 19.6-percent increase in its rate.
The article goes on to falsely conflate the 2017 and 2018 rate increases, however:
I noted back in August that there will only be one insurance carrier offering policies on the Nebraska individual market next year (Medica), with Blue Cross Blue Shield dropping out.
Medica has 35,269 members on their ACA-compliant individual market plans in 2017. But all of the current Aetna enrollees, as well as off-exchange BCBSNE enrollees, will need to switch to Medica plans at the end of 2017, as Medica will be the only insurer offering plans in Nebraska’s individual market for 2018.
A week or so ago, there was some confusing news about how Donald Trump may or may not be planning on signing a new healthcare-related executive order. I didn't write about it earlier because at first it sounded like he was talking about a meaningless "sell across state lines" decree...meaningless because the ACA already allows carriers to sell ACA-compliant policies across state lines, as long as the states in question sign onto an interstate compact.
Ambetter ("Sunflower State") is new to the state, so there's no "rate hikes" to speak of. My confusion was regarding BCBSKS, which is already on the KS exchange but didn't appear to submit any actual "rate change" request last time I checked. Louise Norris has cleared up this mystery:
On October 11, 2013, I posted a diary over at Daily Kos citing CNBC report which made it sound like over 84,000 people had managed to enroll in healthcare policies via the ACA exchanges in the first week and a half, in spite of the massive technical problems at HealthCare.Gov and some of the state exchanges.
It would later turn out that the numbers cited in the article were pretty misleading; while a few states which ran their own exchange websites were indeed off to a good start, some of the data only referred to applications (not actual plan selections), while the numbers out of the main website (HealthCare.Gov) were pathetic at first due to the technical mess (it turned out only six people actually slogged their way through the entire process at HC.gov on Day One).
In U.S. politics, the Hyde Amendment is a legislative provision barring the use of federal funds to pay for abortion except to save the life of the woman, or if the pregnancy arises from incest or rape. Legislation, including the Hyde Amendment, generally restricts the use of funds allocated for the Department of Health and Human Services and consequently has significant effects involving Medicaid recipients. Medicaid currently serves approximately 6.5 million women in the United States, including 1 in 5 women of reproductive age (women aged 15–44).
...The 2016 platform marked the first time the Democratic platform had an explicit call to repeal the Hyde Amendment. On January 24, 2017, the House of Representatives passed H.R. 7, which, according to the press office of Speaker Paul Ryan, "makes the Hyde amendment permanent."
The Cost Sharing Reduction (CSR) payment controversy has been sucking up a huge amount of oxygen over the past 9 months. Most of this is due to Donald Trump repeatedly threatening to cut off the monthly reimbursements to insurance carriers since January, but some of the concern was already there before he even took office. Why? Because the whole reason the CSR payments are at risk of being discontinued in the first place is a federal lawsuit filed by John Boehner on behalf of the House Republican Caucus back in 2014.
The case slowly ground it's way through the judicial process mostly under the radar for a couple of years. Law experts like Nicholas Bagley of the University of Michigan took the view that the case actually had some merit to it on the surface, but should still be shot down due to a lack of standing:
Highmark Blue Cross Blue Shield's 2018 Affordable Care Act marketplace prices will rise by 25 percent, less than it had requested.
The insurer had asked the Department of Insurance for a 33.6 percent increase in June, one month after Aetna announced it would pull out of Delaware's marketplace. The withdrawal will end its coverage of 11,854 Delawareans and make Highmark the only insurance provider in the Delaware marketplace.
...Right now, about 27,000 Delawareans have health insurance through the marketplace. The rate increases will not affect Medicare, Medicaid or coverage by private and government employers.
...Highmark's rate request was based on the uncertain future of Obamacare, especially whether the federal government would or would not enforce the mandate that makes uninsured people either opt in or pay a tax penalty, or continue to make the cost sharing reduction payments, which helps reduce prices for low-income Americans.
