We’re excited to continue our advocacy blog series meant to help you take care when it comes to important arthritis health care and coverage issues. If you are just now tuning into this series, check out our previous blog posts on accumulator adjustment programs, pharmacist gag orders, President Trump’s drug pricing blueprint and drug rebates.
This week we are focusing on the rise in premiums for health plans sold on the Affordable Care Act exchanges. Read on to learn more about how these increases may or may not impact your health insurance options.
How do I know if I will be impacted?
If you purchase health insurance through your employer or if you have Medicaid or Medicare coverage, you will not be impacted. The increases referenced in this blog post and in the associated news headlines are covering proposed 2019 increases in the Affordable Care Act state exchanges. If you do purchase your insurance through your state exchange, contact your state department of insurance to find out which plans are asking for the largest increases.
What’s happening to premiums?
States are currently releasing information about 2019 premium prices, which are proposed by insurers that offer plans on the Affordable Care Act state exchanges. Two of the most recent releases show insurers requested a 19 percent average increase in premiums in Washington state and a 24 percent average increase in New York. These increases are not final, but many states are expected to release similar figures in the coming weeks. In fact, the nonpartisan Congressional Budget Office (CBO) recently released a report estimating an average increase of 15 percent in premiums for 2019 plans sold on Affordable Care Act health insurance exchanges.
Why are premiums rising in the individual market?
According to the CBO, premium increases for 2019 health plans can be mostly attributed to recent federal actions like the repeal of the Affordable Care Act’s individual mandate. The purpose of the individual mandate to purchase insurance was to ensure that state health exchanges had a substantial population of healthy individuals to balance the coverage of consumers who require more expensive care. In New York, insurers attributed half of the proposed increase to repeal of the mandate.
What if I am impacted and my premiums are rising?
Many states, like Washington and New York, will post the percentage increase by insurer on the state department of insurance’s website. The Washington state department of insurance even allows you to sign up and be notified if your insurer wants to change your rates. If your plan’s proposed increase makes your coverage unaffordable, you will need to compare the new plan rates on your local state exchange.
What is my state or the federal government doing about the rise in premiums?
States review all submitted proposed rates to ensure that the rises are justified. If the increases are justified and approved, states have a few strategies to control costs. States may request that insurers consolidate the increases onto silver-level plans to increase subsidies and keep other metal tier plans affordable on the exchange. Other states may also propose a reinsurance program using state and federal dollars to lower consumer costs. However, a reinsurance proposal using federal funds must be approved by the federal government.
The federal government continues to consider proposals to stabilize the individual market. One example is a bipartisan Senate proposal from Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA), which would restore and fund a cost-sharing program cut by the administration that could lower premiums.
How is the Arthritis Foundation advocating on this issue?
The Arthritis Foundation has been very active in advocating for stable state health insurance exchanges. We opposed the individual mandate repeal along with many other patient groups because of concern that it would cause premium increases similar to those in Washington and New York. The Arthritis Foundation also supported the bipartisan Senate proposal from Sens. Alexander and Murray to stabilize the markets and mitigate drastic increases, and we strongly opposed the end of cost-sharing reduction payments that lowered premiums for consumers. The Arthritis Foundation continues to advocate for federal and, where possible, state options, like reinsurance programs, to lower premiums.
We understand that health care costs continue to be a complex issue for patients and all parts of the health care industry. We will continue to work diligently to identify solutions that put patients first. If you’d like to stay informed on federal- and state-based health care issues, consider signing up to be an Advocate. Becoming a part of our advocacy grassroots network is an easy way to get involved and stay informed.
- TAKE CARE: Advocacy Blog Series – Drug Rebates
- TAKE CARE: Advocacy Blog Series – President Trump’s Drug Pricing Blueprint
- TAKE CARE: Advocacy Blog Series – Pharmacy Benefit Manager Gag Orders and Clawbacks
- TAKE CARE: Advocacy Blog Series – Accumulator Adjustment Programs