Health Insurance Plan Rates Stabilize, Offer More Choice for Consumers Despite Federal Government Sabotage
Harrisburg, PA – Insurance Commissioner Jessica Altman today announced that health insurance rates in Pennsylvania have moderated significantly, counter to the national trend, after Wolf Administration efforts to combat the effects of sabotage on health insurance markets by the federal government and specifically the Trump Administration to dismantle the Affordable Care Act (ACA). Importantly, the filings indicate that rate increases in Pennsylvania will be significantly more modest in 2019 than other states and many consumers will see more choices in their local markets as a result of Pennsylvania's efforts to increase competition.
One important twist: A few months back I remember reading that Maine, like several other states, was considering establishing some type of reinsurance program along the lines of successful programs in Alaska, Minnesota and Oregon. I also remember reading that the Maine version was unusual--it would actually involve reestablishing an old, discontinued state program which was still on the books but had been mothballed for years. However, I never got around to doing a write-up about it.
Hot on the heels of Washington State releasing their preliminary 2019 individual market rate hike request comes a similar press release out of the New York Department of Financial Services...and neither the carriers nor the state regulators are making any bones about the reason for next year's rate increases:
PROPOSED 2019 HEALTH INSURANCE PREMIUM RATES FOR INDIVIDUAL AND SMALL GROUP MARKETS
Health insurers in New York have submitted their requested rates for 2019, as set forth in the charts below. These are the rates proposed by health insurers, and have not been approved by DFS.
OLYMPIA, Wash. – Eleven health insurers filed 74 health plans for Washington state’s 2019 individual and family health insurance market, with an average proposed rate increase of 19.08 percent. There are no bare counties, although 14 counties will have only one insurer selling through Washington’s Exchange, Washington Healthplanfinder.
Several quick tidbits out of the District of Columbia from the DC Health Benefit Exchange Authority May board meeting:
Their preliminary 2019 premium rate filings were originally due by May 1st, but this was bumped out until June 1st. Not available publicly yet, however.
The board voted unanimously to restrict Short-Term, Limited Duration plans to no more than 3 months at a time and to make them non-renewable in order to prevent them from further damaging the ACA individual market. They basically went with the parameters laid out under the newly-signed Maryland law. This won't become official unless the DC Council approves it, however (which I strongly suspect will happen).
I just received the following from a healthcare broker, who I trust from past communication exchanges, who wishes to remain anonymous. I'm presenting it as sent, with the only changes being breaking it out into paragraphs for readability & with their state's identifying information removed.
Over the past few weeks I've noted that a half-dozen states or so (Maryland, New Jersey, Vermont, Hawaii, California and Illinois) have been pushing through a long list of bills/laws at the state level to either protect the ACA from sabotage or even strengthen it. Meanwhile, other states have either expanded Medicaid under the ACA (Virginia, of course) or have locked in ballot measures to do so this fall (Utah, Idaho). Finally, several states have announced they're joining dozens of others to take advantage of "Silver Loading" or full-on "Silver Switching".
As shown below, things are pretty cut & dry in Rhode Island; they only have 2 carriers participating in the individual market (Blue Cross Blue Shield and Neighborhood Health Plan). BCBSRI is asking for a 10.7% average increase, while Neighborhood is requesting 8.7% overall.
The estimated market share ratios are based on this press release from HealthSourceRI, the state ACA exchange. That doesn't include the final numbers or the off-exchange enrollment, but it should be pretty close, as there are only 2 carriers and their requested increases are so close to begin with it wouldn't make much difference. The weighted average is 9.3%.
More than 95% of healthcare groups that have commented on President Trump’s effort to weaken Obama-era health insurance rules criticized or outright opposed the proposals, according to a Times review of thousands of official comment letters filed with federal agencies.
The extraordinary one-sided outpouring came from more than 300 patient and consumer advocates, physician and nurse organizations and trade groups representing hospitals, clinics and health insurers across the country, the review found.
Establish a robust reinsurance program to significantly lower insurance premiums for individual market enrollees,
Protect people from out-of-network "balance billing", and
Cancel out Trump's expansion of "Association Health Plans"
(New Jersey actually already had several other "ACA protection" laws on the books in the first place, including protections against short-term plans and "surprise billing".)
In addition, new Governor Phil Murphy had alread proven that he understands and supports the ACA; within days of taking office he had already issued an executive order telling all state agencies to do everything they reasonably can to inform the public about how to enroll during Open Enrollment and so forth.
Sen. Mike SHIRKEY (R-ClarkLake) said today he's hammered out an agreement with the administration and the House on creating work requirements for Medicaid recipients.
Speaking during a taping of "Off The Record," Shirkey said, "We have a deal." All sides have signed off on the exemptions to the work requirement, but he didn't get into all fo them pending a formal announcement coming as soon as later this week.
From the wording of this, it sounds an awful lot like "all sides" appears to refer to Republican Senator Shirkey, the rest of the Republican State Senate, the Republican State House and the Republican Governor.
Shirkey confirmed that the 29-hour job requirement in the Senate bill has been pared back to 20 to which he says, "I was hoping Michigan could take a leadership position and set a new standard for that." But rather than jeopardize the entire package, he compromised.
Kris Haltmeyer, a vice president at the Blue Cross Blue Shield Association, told reporters that the premium increases were in part due to the repeal of ObamaCare’s individual mandate in the Republican tax reform bill in December...“With the repeal of the individual mandate and the failure of Congress to enact stabilization legislation, we are expecting premiums to go up substantially,” Haltmeyer said.
...He said the premium increases are “related to the loss of the mandate and then underlying medical costs.”
“Those two things have the most impact on the rate increases,” he added.
...Oh, and what comes after mandate repeal and underlying medical costs? You guessed it: #ShortAssPlans
One of the things Ford had always found hardest to understand about humans was their habit of continually stating and repeating the very very obvious, as in ‘It’s a nice day’, 'You’re very tall’, or 'You seem to have fallen down a thirty-foot well, are you alright?’
--Douglas Adams, The Hitchhiker's Guide to the Galaxy
A top insurance industry official said Wednesday that he expects “substantial” ObamaCare premium increases for 2019.
Kris Haltmeyer, a vice president at the Blue Cross Blue Shield Association, told reporters that the premium increases were in part due to the repeal of ObamaCare’s individual mandate in the Republican tax reform bill in December. He also cited lawmakers’ failure to pass a bill aimed at lowering premiums, which fell apart earlier this year amid a partisan dispute over abortion restrictions.
The stage is set for a showdown in the Virginia Senate on Tuesday over a budget compromise negotiated by Senate Finance Co-Chairman Emmett Hanger, R-Augusta, and House Appropriations Chairman Chris Jones, R-Suffolk, to expand the state’s Medicaid program and pay for the state’s share through a new tax on hospital revenues that also would boost Medicaid payments for inpatient provider care.
This evening brought three major pieces of ACA-related news out of three different states:
First, in California, the State Senate passed SB-910, which wouldn't just limit short-term plans, but would outright prohibit them altogether. To my knowledge, CA would be the only state* where STPs wouldn't be allowed at all:
(*Correction: It turns out that New York, New Jersey and Massachusetts also ban Short-Term Plans as well, although according to Dania Palanker of the Center on Health Insurance Reforms at Georgetown University, California would be the first state to explicitly outlaw short-term plans as opposed to simply stating that all policies have to meet certain standards.)
SACRAMENTO – Today, the State Senate approved passage of Senate Bill 910, which prohibits the sale of short term limited duration health insurance in California.
