Insurers request hefty premium hikes for 2019 exchange plans

Health insurers in Maryland and Virginia have requested significant premium rate increases for 2019 exchange plans, according to initial filings.

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Maryland's two exchange insurers seek big premium increases

According to initial rate filings, the two insurers that currently sell health plans through Maryland's exchange are seeking average premium rate increases of 30%, when compared with premiums for 2018 exchange plans. Specifically, CareFirst BlueCross BlueShield is seeking an average premium rate increase of 18.5% for its HMO exchange plan and an average premium rate increase of 91.4% for its PPO exchange plan. According to Modern Healthcare, about 90% of CareFirst BlueCross BlueShield's 138,000 exchange plan enrollees in Maryland are enrolled in its HMO plan.

Meanwhile, Kaiser Foundation Health Plan is seeking an average premium rate increase of more than 35%. The insurer currently covers 73,700 Maryland residents through its exchange plans, according to Modern Healthcare.

Overall, the proposed rate increases would raise individual exchange plan premiums in the state from an average of $449 per month for 2018 plans to an average of $592 per month for 2019 plans, Modern Healthcare reports.

The insurers' rate requests must be approved by state regulators.

Maryland Insurance Commissioner Al Redmer on Monday said the proposed rates could end up being lower if the federal government approves a waiver Maryland officials plan to submit to CMS, which would implement a reinsurance program in the state. He said, "We have over the last number of years seen losses that are unsustainable which have resulted in premium increases that are unsustainable."

CareFirst Blue Cross and Blue Shield CEO Chet Burrell on Monday said the company's premium rate requests in Maryland could decline by as much as 20% to 30% if CMS approves a reinsurance program in the state.

Four Virginia insurers seek double-digit premium rate hikes

According to insurer filings in Virginia released Friday, Cigna is seeking to increase premiums for 2019 exchange plans in the state by an average of 15% when compared with premiums for the insurer's 2018 exchange plans. Cigna has 103,264 members enrolled in its exchange plans in Virginia. According to The Hill, the insurer is proposing premium rate increases ranging from 6.4% to 40% in the state.

Meanwhile, Group Hospitalization & Medical Services—a subsidiary of CareFirst BlueCross BlueShield—is seeking to increase its premiums for 2019 exchange plans by an average of 64.3% when compared with 2018 exchange plans, The Hill reports. CareFirst BlueCross BlueShield has about 4,500 members enrolled in its exchange plans in Virginia.

In addition, CareFirst BlueChoice, also a subsidiary of the CareFirst BlueCross BlueShield, is proposing increasing its 2019 exchange plan premiums by an average of 26.6% when compared with 2018 exchange plans. According to FierceHealthcare, CareFirst BlueChoice has about 7,000 members enrolled in its exchange plans in Virginia.

According to Politico's "Pulse," Kaiser Foundation Health Plan of Mid-Atlantic also is seeking a significant rate increase, proposing an average premium hike of 32.1% for 2019 exchange plan premiums when compared with 2018 premiums, while Anthem has proposed an average increase of 5.6%.

Another insurer, Optima, proposed decreasing its 2019 exchange plan premiums in Virginia by an average of 1.9% when compared with its 2018 exchange plans. According to FierceHealthcare, Optima has about 67,000 members enrolled in its exchange plans in Virginia.

State regulators must review and approve the requested changes, The Hill reports.

Reasons for the increases

The insurers cited policies implemented by the Trump administration—such as eliminating the Affordable Care Act's (ACA) individual mandate penalty beginning in 2019—as reasons for the proposed increases. Specifically, the insurers said eliminating the individual mandate penalty could skew their risk pools toward sicker enrollees with higher health care costs, as healthier enrollees are more likely to choose to forgo health coverage without the threat of being penalized.

Cigna also cited "anticipated changes to regulations" on short-term and association health plans as a reason for its requested increases.

ACA advocates, Democrats blame GOP for proposed premium hikes

Protect Our Care Campaign, a pro-ACA group, blamed Republicans for the proposed premium hikes. "Until we stop Republicans' war on health care, health care experts predict that rates will keep rising by double digits," the group's director, Brad Woodhouse, said in a statement. He continued, "D.C. Republicans should start working on bipartisan solutions to make coverage more affordable."

Democratic lawmakers also blamed Republicans for the proposed increases. Sen. Tim Kaine (D-Va.) in a Facebook post wrote, "Let's be clear what this is: a painful consequence of the Trump administration's efforts to sabotage the health insurance market and dismantle the [ACA]." He added, "After a series of unsuccessful attempts to repeal the ACA, President Trump and Republicans in Congress settled for taking actions that will increase premium costs for American families."

Rep. Don Beyer (D-Va.) in a tweet wrote, "There is no way to sugarcoat these health insurance premium hikes: they are across different insurers, they are devastating, and many will not be able to afford them" (Livingston, Modern Healthcare, 5/7; Weixel, The Hill, 5/7; Weixel, The Hill, 5/4; Stankiewicz, FierceHealthcare, 5/6; Pradhan, "Pulse," Politico, 5/7).

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