BCBSA: ACA premiums in 23 states expected to rise an average 2.3% in 2020

Preliminary rates for Affordable Care Act (ACA) insurance exchanges across 23 states show insurers want a median 2.3% increase for 2020, according to a new analysis.

The figures provided by the Blue Cross Blue Shield Association point to another round of likely minimal premium hikes for the 2020 coverage year.

The preliminary filings range from an 18% decrease in Colorado to a 13% increase in New Mexico, said Kris Haltmeyer, vice president of legislative and regulatory policy for the association, in a Thursday briefing with reporters.

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The Centers for Medicare & Medicaid Services (CMS) approved a waiver by Colorado in July to set up a reinsurance program to lower premiums for ACA plans in 2020.

“Where states are putting in place reinsurance programs, we are seeing substantial reductions,” Haltmeyer said.

CMS has approved reinsurance waivers for 13 states as of Aug. 29, according to data from the Kaiser Family Foundation.

The initial filings would still need to be approved by state regulators before open enrollment for the 2020 coverage year begins Nov. 1.

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But the association was heartened by the initial results.

“We really see this market stabilize over the last couple of years,” said Justine Handelman, senior vice president of policy and representation. “We have seen competition come back.”

A recent survey from eHealth also found that a majority of insurers plan to increase the number of ACA plans offered in 2020.

However, a recent report by CMS found the uninsured population on the exchanges has declined dramatically in the past few years. In 2017, 1.3 million unsubsidized ACA customers left the exchanges, and in 2018 another 1.2 million left.

“These enrollment declines among unsubsidized enrollees coincided with increases in average monthly premiums of 21% in 2017 and 26% in 2018,” according to CMS.

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Handelman said a legislative proposal from the association earlier this year sought to contain those costs by creating a federal reinsurance program and adjust the ACA's tax credits.

Trump administration critics also charge that CMS regulations expand access to association health plans and short-term plans, which are cheaper than ACA plans but offer fewer benefits. Critics have worried that exchange customers would flock to the cheaper plans and destabilize the exchange risk pool.

Haltmeyer said it is too early to say how the expansion of those plans has affected the exchanges.