Trump caus­ing big cost hikes in health poli­cies

Mixed sig­nals lead­ing in­sur­ers to seek larger in­creases, study finds.

Los Angeles Times - - BUSINESS BEAT - As­so­ci­ated press

Ac­tions by the Trump ad­min­is­tra­tion are trig­ger­ing dou­ble-digit pre­mium in­creases on in­di­vid­ual health in­surance poli­cies pur­chased by many peo­ple, ac­cord­ing to a non­par­ti­san study.

The anal­y­sis re­leased Thurs­day by the Kaiser Fam­ily Foun­da­tion found that mixed sig­nals from Pres­i­dent Trump have cre­ated un­cer­tainty “far out­side the norm” and led in­sur­ers to seek higher pre­mium in­creases for 2018 than would oth­er­wise have been the case.

Repub­li­cans in Congress have not de­liv­ered on their prom­ise to re­peal and re­place the Obama-era Af­ford­able Care Act. Trump is in­sist­ing that law­mak­ers try again and that Obama’s sig­na­ture health over­haul is col­laps­ing. At the same time, he has threat­ened to stop bil­lions of dol­lars in pay­ments to in­sur­ers. Some Repub­li­cans are con­sid­er­ing fall­back mea­sures to sta­bi­lize mar­kets.

Kaiser re­searchers looked at pro­posed pre­mi­ums for a bench­mark sil­ver plan across ma­jor metropoli­tan ar­eas in 20 states and Wash­ing­ton, D.C. Over­all, they found that 15 of those cities will see in­creases of 10% or more next year.

The high­est is a 49% jump in Wilm­ing­ton, Del. The only de­cline: a 5% re­duc­tion in Prov­i­dence, R.I.

About 10 mil­lion peo­ple who buy poli­cies through Health­Care.gov and staterun mar­kets are po­ten­tially af­fected, as are 5 mil­lion to 7 mil­lion who buy in­di­vid­ual poli­cies on their own.

Most of those in the gov­ern­ment-spon­sored mar­kets can dodge the hit with the help of tax cred­its to help pay pre­mi­ums. But off­mar­ket­place cus­tomers pay full freight, and they face a sec­ond con­sec­u­tive year of steep in­creases. Many are self-em­ployed busi­ness own­ers.

The re­port found in­surer par­tic­i­pa­tion in the Af­ford­able Care Act mar­kets will be lower than at any time since they opened for busi­ness in 2014. The av­er­age is 4.6 in­sur­ers in the states stud­ied, down from 5.1 in­sur­ers this year. In many cases, in­sur­ers do not sell plans in ev­ery com­mu­nity in a state.

The re­searchers an­a­lyzed pub­licly avail­able fil­ings through which in­sur­ers jus­tify their pro­posed pre­mi­ums to state reg­u­la­tors. In­sur­ers are strug­gling with sicker-than-ex­pected cus­tomers and dis­ap­point­ingly low en­roll­ment, and an in­dus­try tax is ex­pected to add 2 to 3 per­cent­age points to pre­mi­ums next year.

On top of that, re­searchers found that mixed sig­nals from the ad­min­is­tra­tion ac­count for some of the higher charges. Those could in­crease be­fore en­roll­ment starts Nov. 1.

“The vast ma­jor­ity of com­pa­nies in states with de­tailed rate fil­ings have in­cluded some lan­guage around the un­cer­tainty, so it is likely that more com­pa­nies will re­vise their pre­mi­ums to re­flect un­cer­tainty in the ab­sence of clear an­swers from Congress or the ad­min­is­tra­tion,” the re­port said.

In­sur­ers that as­sumed that Trump would make good on his threat to stop bil­lions of dol­lars in pay­ments to sub­si­dize co­pay­ments and de­ductibles re­quested ad­di­tional pre­mium in­creases rang­ing from 2% to 23%, the re­port found.

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