Uncertainty driving up marketplace premiums

by WisPolitics.com

Wisconsin insurers that participate in Healthcare.gov are requesting double-digit premium increases for individuals next year, citing a population that's less healthy than expected and a marketplace that isn't profitable.

The filings reflect increasing uncertainty over the health care marketplace, with some insurers citing concerns about cost sharing reduction payments being cut off. President Donald Trump has weighed eliminating those subsidies.

The increased premiums will be accompanied by higher tax credits for Healthcare.gov consumers to pay for them, though those above 400 percent of the federal poverty level don't qualify for credits.

At this point last year, most insurers also requested double digit premium increases, though a handful of insurers had requested more modest increases and one, MercyCare, had actually proposed cutting its rates. Three insurers – Anthem, Health Tradition Health Plan and Molina Healthcare – already said they won't participate in 2018.

Molina pulled out Aug. 2, announcing it’s “taken aggressive and urgent steps to substantially improve” its financial performance after a disappointing second quarter. That includes exiting the Healthcare. gov marketplaces in both Utah and Wisconsin, though Molina is reviewing its presence in other states.

The premium requests are preliminary and pending approval from the state Office of the Commissioner of Insurance. OCI spokeswoman Elizabeth Hizmi said the agency expects to send its initial review of the filings to the feds this month, though she noted the rate requests can change in the coming months.

The final rates, she said, will be posted on Nov. 1 when the feds begin open enrollment for Healthcare.gov plans next year.

The news came as Gov. Scott Walker stepped up his role in the health care arena following U.S. Senate Republicans’ failure to pass a plan to replace Obamacare. Walker, also head of the Republican Governors Association, was in Washington, D.C. on July 31 for a White House meeting.

Walker said progress was made but noted health care is “a fairly complicated issue and we weren't looking to resolve it all in one meeting.”

“But we'll hopefully continue to have ongoing discussions with the folks in Washington and governors who are really at the forefront,” Walker said. “States are much more effective, much more efficient, much more accountable, and I think it's refreshing to see that they're interested in what governors have to say.”

Walker's meeting followed his release of a statement urging Congress to give states block grants to fund health care programs along with “full responsibility” over what they look like.

Unity Health Plans, which is requesting premium increases around 30 percent, said the ACA population it covers has had higher medical costs than expected. Unity spokeswoman Jennifer Dinehart said the company doesn't “anticipate any further changes to our rates at this time.”

Network Health is asking for a 43 percent increase in one of its exchange plans and a 25 percent increase in another.

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