Premium increases projected to be modest in 2019
Premiums for Affordable Care Act individual insurance coverage are set to rise much more modestly in 2019 than in previous years.
Consumers will pay premiums that are 3.6% higher on average in 2019, according to an analysis of proposed and approved premiums across 47 states and Washington, D.C., by the Associated Press and consulting firm Avalere Health.
In 2018, premiums in states that used the Healthcare.gov exchange rose an average of 30% over the previous year as insurers hiked rates to protect their profits from the loss of cost-sharing reduction payments and the prospect of a zeroed out individual mandate penalty.
Premium increases are lower this year because insurers hiked premiums so drastically in the past. Still, some experts following the ACA individual market say premiums would be even lower if the individual mandate penalty remained and the Trump administration had not expanded access to skimpy, non-ACA-compliant plans.
"Insurers are very profitable right now in the individual market following previous increases that overshot what was needed, so they can't justify big increases," Larry Levitt, senior vice president at the Kaiser Family Foundation, tweeted.
Independent analyst Charles Gaba, who tracks ACA premiums and enrollment at ACASignups.net, has similarly projected that individual premiums will rise less than 4% next year. But he estimated that premiums would decrease about 5% if the individual mandate penalty—set to be zeroed starting in 2019—remained in place, and access to short-term, limited-duration plans remained limited.
Starting in 2019, consumers can buy short-term plans that last up to 12 months and can be renewed for a maximum period of 36 months. Previously, the Obama administration had limited the plans, which don't cover the essential health benefits or pre-existing conditions, to three months. The Trump administration also expanded access to association health plans, which are not subject to ACA consumer protections.
The analysis by the AP and Avalere Health also found that premiums are expected to drop or increase by less than 10% in 41 states where 9 million customers are enrolled in individual coverage. Average premiums are expected to decrease in 11 of those states. Still, premiums will likely rise between 10% and 18% in six other states and Washington, D.C.
The analysis also found that 19 states will see new insurers, or existing insurers will expand into more areas of the state. Indeed, while several national health insurers, including UnitedHealth and Aetna, have largely quit selling ACA exchange coverage because of initial financial losses, many others that remained are turning a profit and some are expanding into new geographies. Oscar Health, for instance, said it will sell exchange plans in six new markets in 2019. Officials at Centene Corp., which sells exchange plans in 16 states, have said they "remain very bullish" about that business.
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