New York in­sur­ers seek dou­ble-digit health pre­mium in­creases

Modern Healthcare - - REGIONAL NEWS - —Caro­line Lewis, Crain’s New York Busi­ness

New York’s health in­surance com­pa­nies are seek­ing pre­mium rate in­creas- es av­er­ag­ing 16.6% in the in­di­vid­ual mar­ket and 11.5% in the small-group mar­ket next year. The Cuomo ad­min­is­tra­tion is re­view­ing the re­quests pub­lished last week on the web­site of the Depart­ment of Fi­nan­cial Ser­vices, which ul­ti­mately sets each in­surer’s rate.

In­sur­ers have com­plained that the state in re­cent years has kept rates ar­ti­fi­cially low. But it’s a bal­anc­ing act. Pre­mi­ums that are too low can drive in­sur­ers out of the mar­ket or, in the case of Health Re­pub­lic In­surance of New York, bank­rupt them when pre­mi­ums don’t cover costs.

How­ever, that del­i­cate bal­ance could be thrown out of whack this year if Gov. An­drew Cuomo makes good on his re­cent threat to ban in­sur­ers that leave the mar­ket­place set up un­der the Af­ford­able Care Act from par­tic­i­pat­ing in Med­i­caid. In­sur­ers have ques­tioned the le­gal­ity of Cuomo’s di­rec­tive. The Demo­crat has moved to main­tain the Oba­macare ex­changes, where nearly a quar­ter-mil­lion New York­ers get their in­surance.

Unit­edHealth­care is look­ing for the big­gest pre­mium rate in­crease in the down­state area: 38.5% for plans in the in­di­vid­ual mar­ket. Last year it sought a 45.6% in­crease, but the state granted it a hike of 28%. On the lower end, NYC Health & Hos­pi­tals’ Metro-Plus re­quested a pre­mium rate in­crease of 7.9%. Last year MetroPlus asked for an av­er­age in­crease of 20.3% across its plans. The state ul­ti­mately in­creased that re­quest to 29.2%.

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