Health-Plan Rates in State’s Individual Market Could Go Up an Average of 22 Percent

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The Seattle Times 

Health-insurance rates in Washington’s individual market would increase an average of 22 percent next year based on filings under review by state officials — sparking a new round of partisan finger-pointing.

The increases are almost twice the 13.5 percent increase insurers proposed this past year for 2017. Consumer options also would decrease next year for the 300,000 Washingtonians who buy their health coverage in the marketplace for individuals.

This year 13 insurers offered 154 plans in Washington’s individual market and nine companies sold plans inside the state exchange created under the Affordable Care Act, also known as Obamacare.

Next year 11 insurers would offer 71 plans with just seven companies selling inside the exchange. No insurers plan to offer individual market coverage in rural Klickitat County, although that may change.

Elected officials blamed the opposing party for the squeeze on consumers.

State Insurance Commissioner Mike Kreidler, a Democrat, called out Republicans in Washington, D.C., for sowing uncertainty in the health-insurance market that drove rates up and decreased coverage plans.

U.S. Reps. Cathy McMorris Rodgers and Dan Newhouse, two of Washington’s Republicans in Congress, pointed to flaws in the ACA that make it unsustainable.

“Blame should be shared by all sides,” said Joe Antos, an analyst with the American Enterprise Institute, a nonpartisan business-oriented think tank in Washington, D.C.

Clearly, Antos said, uncertainty about Republicans’ plans for replacing Obamacare is contributing to insurers’ decisions to pull out of some individual marketplaces.

Whether Republicans will continue cost-sharing subsidies for insurers is a major unknown and a “big factor,” Antos said.

But he also said instability comes from aspects of the ACA, such as not allowing insurers to deny coverage to people with pre-existing conditions or charge them higher rates.

“I’m not arguing against social welfare,” Antos said. “The challenge Obama didn’t take up and Republicans in Congress are having problems with is how to make this operate more like business than a forced charitable operation.”

At the same time, he said, marketplace corrections by the industry also play a part in the proposed increases in Washington.



According to Antos, this year’s rates were based on more data about the impact of the ACA, which took effect in 2014. Insurers continue to make adjustments as they get a better understanding of their customers and costs, he said.

Initially, Antos said, insurers not only lacked information, but they also probably lowballed prices as they were breaking into new markets.

That’s one reason this year’s rates averaged a 13.5 percent jump over 2016 rates, which increased only 4 percent over the previous year. The new proposed rates are likely another correction, padded with uncertainty about cost-sharing subsidies that amount to about $7 billion a year nationally.

“When there is no clear policy going forward, actuaries take that into account and build in a financial cushion,” he said. Add the GOP uncertainty, ACA flaws and actuarial cushion together, and you get a 22 percent increase, he said.

“I know these numbers will be extremely upsetting to people who buy their own health insurance. They’re upsetting to me,” said Kreidler said in a statement. His staff will review the filings in coming months to make sure the increases are warranted.

Most Washingtonians have employer-sponsored health insurance. Another 600,000 gained coverage through the ACA’s expansion of Medicaid for lower-income people.

The proposed increases range from 12.9 percent for Kaiser Foundation Health Plan of Washington (formerly Group Health Cooperative) to 38.5 percent for Molina Healthcare of Washington.

Once Kreidler’s review is done, the exchange will certify plans for sale in Washington Healthplanfinder on Sept. 14. Open enrollment for the 2018 individual market starts Nov. 1.

As of Monday morning, insurers did not expect to offer plans in either Klickitat or Grays Harbor counties. But Kreidler announced later Monday that Premera Blue Cross — the last insurer to offer exchange plans in the two counties — would offer two plans in Grays Harbor County.

Kreidler said he is optimistic that further discussions would lead at least one insurer to offer plans in Klickitat County.

Antos said the lack of insurers in rural counties is not unusual nationally. But it’s a problem best solved in the state. “What you do is allow a reasonable increase in premiums to help that company cover costs in the largely unoccupied counties,” he said.

In the meantime, Democrats such as Washington Sens. Patty Murray and Maria Cantwell continued to criticize Republicans for meeting in secret and planning to vote on a bill without open hearings.

And Republican Newhouse returned fire. “The nationwide trend of fewer options and rising insurance rates began long before repeal efforts of the current administration and the current Congress,” Newhouse said Monday in a statement.