Health law premiums to fall, number of insurers to rise next year

WASHINGTON — Nearly three years into President Donald Trump’s aggressive efforts to undermine the Affordable Care Act, prices for the most popular type of health insurance plan offered through the health law’s federal marketplace will actually drop next year, and the number of insurers offering plans will go up.

Administration officials credited Trump with the resiliency of the law even as they echoed his contempt for it.

“The ACA simply doesn’t work and is still unaffordable for far too many,” Alex Azar, the secretary of health and human services, said Monday. “But until Congress gets around to replacing it, President Trump will do what he can to fix the problems created by this system for millions of Americans.”

The 4 percent price decline is only the second time that average monthly premiums have dropped year-to-year since the marketplace opened in 2014, and it is a sign that the health law is stabilizing after several years of turmoil caused in part by Trump. Open enrollment for “Obamacare” starts Nov. 1, but looming over it is an impending court decision on the law’s constitutionality in a case supported by the Trump administration that seeks to overturn the law.

Premiums rose sharply in the final years of the Obama administration, as Trump officials like to point out, largely because of losses insurers suffered as they tried to gauge the health needs of their new customers. But after Trump and Republicans in Congress tried unsuccessfully to repeal the law in 2017, the president took a number of steps to weaken it, all of which led to uncertainty that resulted in insurers raising prices.

Now, a correction is taking place. Some of the states with the biggest premium increases this year, including Delaware and

North Dakota, will see the biggest decreases in 2020. There will be 20 more insurers selling plans next year in the federal marketplace, which is used by people in 38 states, bringing the total to 175. That will be the largest number of issuers since 2016. Only two states, Delaware and Wyoming, will have a single insurer selling plans under the law next year, compared with five states currently.

For a 27-year-old, premiums for a benchmark “silver” plan will cost an average $388 per month next year; for a family of four, they will average $1,520 per month. That is still expensive, but most people will qualify for federal subsidies that cover much or most of the cost.

For many of those who do not qualify for subsidies under the health law — people earning more than 400 percent of the poverty level, which comes to just under $50,000 for a single person — premiums will remain out of reach.

Deductibles, too, will continue to rise, with the median amount rising to $4,604, from $4,471, for silver plans, which offer midlevel coverage. But people whose income is at or under 200 percent of the poverty level will have much lower deductibles, thanks to a different kind of discount required under the law that helps with out-of-pocket costs.