Category: Exchanges

This year will be the last in which uninsured Americans are forced to pay ObamaCare’s penalty for lack of coverage. The change—part of the GOP’s tax reform—comes as relief on the demand side of health insurance. Yet nothing has changed on the market’s supply side. Without additional reforms to ObamaCare’s restrictions on insurers, millions of Americans will continue to choose from a limited range of lackluster plans.

Insurers on the District of Columbia’s Obamacare insurance exchange want to raise rates by nearly 15 percent in 2019, while Minnesota’s insurers propose to reduce rates by up to about 12 percent.

Insurers in Minnesota can take advantage of a reinsurance program in which the state helps subsidize the biggest insurance claims on Obamacare’s insurance exchanges. Efforts to create a federal reinsurance program ran aground in the Senate because of disagreements over abortion funding.

In Minnesota, all of the state’s five Obamacare insurers are asking for proposed rate reductions of 3 to 12 percent for certain plans. That is a major difference from the final rates for the 2018 coverage year, which ranged from a 16 to 32 percent hike.

ObamaCare enrollees should brace themselves for another year of double-digit premium hikes.

Average premiums for plans sold through the state and federal insurance exchanges will jump as much as 32% next year, according to a recent report from actuarial firm Milliman. Consumers in some markets could face 80% rate hikes, according to a separate analysis from Blue Cross Blue Shield.

Democrats have pounced on these projections to blame the GOP for “marketplace sabotage.” Senate Minority Leader Chuck Schumer, D-N.Y., remarked that “Republicans and the Trump administration own any and all increases in health care premiums for American consumers.”

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The Affordable Care Act (ACA) established health insurance marketplaces where consumers can buy individual coverage. Leveraging novel credit card and bank account micro-data, we identify new enrollees in the California marketplace and measure their health spending and premium payments. Following enrollment, we observe dramatic spikes in individuals’ health care consumption. We also document widespread attrition, with more than half of all new enrollees dropping coverage before the end of the plan year. Enrollees who drop out re-time health spending to the months of insurance coverage. This drop-out behavior generates a new type of adverse selection: insurers face high costs relative to the premiums collected when they enroll strategic consumers. We show that the pattern of attrition undermines market stability and can drive insurers to exit, even absent differences in enrollees’ underlying health risks. Further, using data on plan price increases, we show that insurers largely shift the costs of attrition to non-drop-out enrollees, whose inertia generates low price sensitivity. Our results suggest that campaigns to improve use of social insurance may be more efficient when they jointly target take-up and attrition.

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Consumers and insurers face new uncertainty with the Justice Department’s assertion this week that key provisions of the Affordable Care Act are invalid.

In a brief filed Thursday, the department asked a federal court to unwind the health law’s protections for individuals with existing medical conditions, such as diabetes or asthma. The law, known as Obamacare, prohibits insurers from refusing to sell coverage to people with pre-existing conditions or from charging them more than healthy consumers.

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Federal officials will not block insurance companies from again using a workaround to cushion a steep rise in health premiums caused by President Donald Trump’s cancellation of a program established under the Affordable Care Act, Health and Human Services Secretary Alex Azar announced Wednesday.

The technique — called “silver loading” because it pushed price increases onto the silver-level plans in the ACA marketplaces — was used by many states for 2018 policies. But federal officials had hinted they might bar the practice next year.

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Even health insurers that don’t expect many of their plan members to drop insurance coverage after the individual mandate penalty is zeroed out still may have to raise individual market premiums in 2019 as their payments from the ACA’s risk adjustment program change thanks to the mandate loss.

Buffalo, N.Y.-based insurer Independent Health doesn’t expect a large number of its 5,000 ACA exchange members to drop their coverage when the individual mandate penalty is effectively repealed starting in 2019. Its population skews older and sicker, and most members need their insurance coverage. Its average member is about 49 years old, and about half receive federal premium subsidies.

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Health insurers are asking Washington state regulators to allow them to raise the price of Obamacare premiums in 2019 by an average of 19 percent.

Under the latest proposals made public Monday, no county in the state will be left without an Obamacare insurer, a type of medical coverage offered to customers who do not get health insurance through a job or government program. Still, 14 counties would have only one insurer to choose from, which will limit their options and the doctors and hospitals that will be in their network.

State Insurance Commissioner Mike Kreidler blamed the Trump administration’s changes to Obamacare for the increases.

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The Trump administration is not sabotaging the nation’s insurance system — it’s trying to make health plans more affordable. That’s the intent behind the administration’s recent proposal to expand access to short-term plans.

“These plans aren’t subject to many of the regulations that have sent exchange premiums soaring. As a result, they’re significantly cheaper. The average premium for a short-term individual plan at the end of 2016 was only $124 per month. Obamacare-compliant plans, on the other hand, cost an average of $393 per month.”

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In recent elections, Democrats have faced attacks related to health-care costs, with the party being blamed for premium increases on Affordable Care Act exchanges during the Obama years.