Un­cer­tainty to drive health pre­mi­ums up for ’18, re­port finds

Northwest Arkansas Democrat-Gazette - - BUSINESS & FARM - RI­CARDO ALONSO-ZALDIVAR

WASH­ING­TON — Ac­tions by Pres­i­dent Don­ald Trump’s 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 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 former Pres­i­dent Barack Obama’s Af­ford­able Care Act. Trump is in­sist­ing that law­mak­ers try again and that the health over­haul is col­laps­ing. At the same time, he’s 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 per­cent or more next year.

The high­est is a 49 per­cent jump in Wilm­ing­ton, Del. The only de­cline: a 5 per­cent re­duc­tion in Provi-

● dence, R.I.

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

Those in the gov­ern­mentspon­sored mar­kets can dodge the hit with the help of tax cred­its that most of them qual­ify for to help with pre­mium pay­ments. But off-mar­ket­place 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-thanex­pected cus­tomers and dis­ap­point­ing 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. Once pre­mi­ums are set, they’re gen­er­ally in place for a whole year.

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

In­sur­ers that as­sumed the IRS un­der Trump would not en­force un­pop­u­lar fines on peo­ple who re­main unin­sured re­quested ad­di­tional pre­mium in­creases rang­ing from 1.2 per­cent to 20 per­cent.

“In many cases that means in­sur­ers are adding dou­bledigit pre­mium in­creases on top of what they oth­er­wise would have re­quested,” said Cyn­thia Cox, a co-au­thor of the Kaiser re­port. “In many cases, what we are see­ing is an ad­di­tional in­crease due to the po­lit­i­cal un­cer­tainty.”

In a in­ter­view ahead of his in­au­gu­ra­tion, Trump said, “We’re go­ing to have in­surance for ev­ery­body.”

“There was a phi­los­o­phy in some cir­cles that if you can’t pay for it, you don’t get it,” he added. “That’s not go­ing to hap­pen with us.”

Peo­ple cov­ered un­der Obama’s law “can ex­pect to have great health care,” Trump said at the time. “It will be in a much sim­pli­fied form. Much less ex­pen­sive and much bet­ter.”

But the White House never pro­duced the health care pro­posal Trump promised. The Repub­li­can bills in Congress would have left mil­lions more unin­sured, a sober­ing side-ef­fect that con­trib­uted to their po­lit­i­cal undoing.

The ad­min­is­tra­tion sidestepped ques­tions about its own role raised by the Kaiser study.

Spokesman Alleigh Marre said ris­ing pre­mi­ums and dwin­dling choices pre­date Trump.

“The Trump ad­min­is­tra­tion

is com­mit­ted to re­peal­ing and re­plac­ing Oba­macare and will al­ways be fo­cused on putting pa­tients, fam­i­lies, and doc­tors, not Wash­ing­ton, in charge of health care,” Marre said in a state­ment.

The tur­moil for peo­ple who buy in­di­vid­ual health in­surance stands in sharp con­trast to rel­a­tive calm and sta­bil­ity for the ma­jor­ity of Amer­i­cans in­sured through work­place plans. The cost of em­ploy­er­spon­sored cov­er­age is ex­pected to rise about 5 or 6 per­cent next year, ben­e­fits con­sul­tants say.

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