Dive Brief:
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While other states have seen payers request double-digit premium increases in the individual market, Pennsylvania payers are only seeking an average 4.9% increase for 2019.
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Pennsylvania Insurance Commissioner Jessica Altman credited the state’s competitive Affordable Care Act marketplace and the department's efforts to maintain individual market enrollment as reasons for the modest rate increase proposals.
- Meanwhile, New York officials are blaming Congress ending the individual mandate penalty for their large premium increase requests.
Dive Insight:
States across the country are lamenting proposed double-digit premium increases for 2019. While many states worry there will be less competition in the individual market next year, Pennsylvania is seeing an uptick of participation in the exchange.
In 2019, 31 of the state’s 67 counties will have more payers offering individual coverage. The number of counties with only one payer offering individual coverage will drop from 20 to eight next year, according to the state.
“Our review of the requested rate changes shows that the health insurance market in Pennsylvania is becoming more competitive to the benefit of consumers,” Altman said. “Although rates will not be finalized until this fall, I’m encouraged by the aggregate numbers and pleased to see that consumers across Pennsylvania will have more choices to cover their health needs.”
Pennsylvania said it has worked 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,” according to a statement.
In addition to the 4.9% increase proposal for individual insurance, insurers in the small group market requested an aggregate statewide increase of 3%.
It’s much different in neighboring New York. Payers in the Empire State are proposing an average 24% rate increase for 2019. The New York Department of Financial Services said 11.9% of the 24% increase is because of Congress stopping the individual mandate penalty. New York estimated the rate increases would have been 12.1% if the penalty was still in effect for 2019.
Critics charge that losing the individual mandate will cause younger, healthier people to drop coverage or find cheaper plans outside of the exchanges. This will leave an unstable risk pool with sicker members, which will lead to even higher premiums.
A recent joint report from the Center for Health Policy at the Brookings Institution and the USC Schaeffer Center for Health Policy & Economics predicted that ending the mandate could result in millions dropping or losing health insurance in the coming years.
Meanwhile, on the other side of the country, Washington said 11 payers filed 74 health plans for 2019 for individual and family health insurance market with an average proposed rate increase of 19.08%. Washington expects 14 counties will only have one insurer in the state’s exchange, Washington Healthplanfinder.
Washington Insurance Commissioner Mike Kreidler said the rate requests are actually lower than he expected. Much like other state insurance commissioners, Kreidler pointed to Washington, D.C., to explain “a great deal of uncertainty in the individual markets,” including the Trump administration’s plan to expand short-term health plans and association health plans (AHPs).
Critics charge that expanding those two types of plans will cause people to flee the individual market, especially those who don’t qualify for federal subsidies. A recent report from the Society of Actuaries said expanding AHPs will result in up to 10% of people in ACA plans leaving the marketplace for lower-cost AHPs.