Health insurers have warned that without more policy certainty—particularly for cost-sharing reduction payments—they would be forced to request steep rate hikes in the individual marketplaces.
Now, their predictions are proving true.
In Mississippi, for example, the insurance commissioner approved a 47.4% average rate increase for the state’s single Affordable Care Act exchange insurer, The Wall Street Journal reports. The increase would have been just 17.9% if CSR payments were guaranteed next year.
Connecticut approved a 31.7% premium increase for Anthem and a 27.7% increase for ConnectiCare, the article adds, and Kentucky, Mississippi and Virginia all are approving rates for major insurers that are at least 25% higher than rates were this year.
In Illinois, state regulators submitted rates to the federal government that would increase the average cost of the lowest-priced silver plans by 35%, the Chicago Tribune reports. The lowest-priced bronze plans in the state will see an average 20% rate hike, while premiums for the lowest-priced gold plan will increase 16% on average.
Premium tax credits, which increase when premiums go up, will shield many ACA exchange customers from such steep increases, but not all enrollees qualify for those subsidies.
This Wednesday was the deadline for 2018 premium rates to be locked in by the federal government, and by next Wednesday, insurers must sign final contracts indicating their participation in the exchanges. Leading up to the latter deadline, insurers are unlikely to receive any more encouraging signs from the government.
The Senate HELP Committee’s efforts to craft an ACA stabilization bill—which might have guaranteed funding for CSR payments—has stalled amid Republicans’ last-ditch effort to repeal and replace the healthcare law. Perhaps unsurprisingly, the health insurance industry’s two major trade groups have come out against the GOP’s bill, which would repeal many of the ACA’s key provisions and replace them with block-grant funding to states.
At last count, there are no U.S. counties set to be without an ACA exchange insurer in 2018, but with uncertainty persisting, that could still change.
But while some departures may happen, many insurers may think twice about exiting the exchanges at the last minute, Sabrina Corlette, a research professor at Georgetown’s Center on Health Insurance Reforms, told The Hill. “I think carriers recognize how dire the consequences are if they do make such a late decision on the customers that they serve,” she said.