The average proposed or approved premium increase for Affordable Care Act plans for 2019 is 3.6%, according to a new analysis by the Associated Press and Avalere Health. That percentage covers 47 states and Washington, D.C., and is a far cry from the double-digit increases of prior years.
The researchers found that 11 states are expecting an average premium decrease with 41 states either increasing or decreasing rates by less than 10%.
In other ACA exchange news, eHealth released results from a survey of payers in the marketplace showing that 93% plan to expand or maintain their footprint, a percentage twice as high as the result from an earlier survey in March of this year.
Following a year of concern about hefty rate increases and the possibility of counties not having any ACA plan options, 2019 is shaping up to be a stable year for the exchanges. Experts don't anticipate any bare counties, unlike last year when state regulators scrambled to make sure ACA plans covered every county.
Plus, the expected premium increases are much smaller than 2018, partly because of the hefty, double-digit increases last year. Chris Sloan, director at Avalere Health, on Twitter pointed to Avalere's findings that the ACA exchanges' volatility is "plateauing" for now.
Meanwhile, the eHealth survey results echoed AP/Avalere's research on modest premium increases. eHealth said half of respondents plan to raise premiums between 5% and 10% and one-quarter plan reductions. The other quarter said they expect no premium changes.
Despite concerns raised by studies and individual mandate advocates, eHealth found that most payers don't expect the individual mandate penalty repeal will significantly impact ACA plan enrollment in 2019. The company said 54% of respondents don't expect an enrollment impact and 73% noted the repeal didn't significantly affect their strategy for 2019.
A minority of payers plan to make changes to benefit design and provider networks. eHealth found that slightly more than one-third of payers expect to alter their plan offerings in 2019. The same amount (36%) said they plan to restrict their provider networks.
In another report, eHealth found that payers are warming to short-term health plans. The survey found that 80% of payers surveyed said short-term plans are a necessary option for people who can't afford ACA plans. That's more than double the number from February, when eHealth asked the same question to payers. Nearly three-fourths of payers surveyed said they plan to offer short-term plans.
At the moment, the ACA limits short-term plans to young people and those who can't afford ACA plans and they are limited to three months. However, the Trump administration plans to open short-term plans to anyone next year and to let people keep the plans for a year with the ability to renew for three years.
Short-term plan advocates say they offer an affordable option for people who want catastrophic health insurance. However, critics charge the plans don't provide enough coverage and will result in people (especially those who are healthy) to flee the exchanges, leaving an unbalanced risk pool.
Nearly 90% of payer respondents said the short-term health plan rule change won't affect their business strategy, but many insurers also said they aren't sure whether they'll make changes to short-term plans. Less than one-fifth of respondents (18%) said they plan to add some level of coverage for pre-existing conditions to short-term benefits in 2019.